Patient Care Advocate - WellBe Senior Medical : Job Details

The WellBe care model is a Physician Led Advanced Practice clinician driven geriatric care (care of older adults) team focused on the care of the frail, poly-chronic, elderly Medicare Advantage patients. This population is typically underserved and very challenged with access to care. To address these problems, we have elected to bring the care to the patient, instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care – from chronic careand urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care. WellBe's physician/advanced practicing clinician led geriatric care teams' partner with the patient's primary care physician to provide concierge level geriatric medical care and social support in the home as well as delivering and coordinating across the entire care continuum.

GENERAL SUMMARY

Our Patient Care Advocate are the energetic, curious explorer, part of a team that provides compassionate care to the frailest elderly who suffer from chronic and acute illnesses or injuries living in their homes. Our PCA is responsible for developing a rapport, and delivering exceptional in-home services, helping coordinate care with the rest of the medical team, scheduling patient appointments with our team, specialist appointments and coordinating diagnostic tests, HEDIS gap closure, being a community resource, working to engage patients that currently are not engaged, and contributing complete and accurate data in patient's records, and other tracking tasks. The successful candidate will love working with seniors and a collaborative interdisciplinary team. We offer a positive, upbeat work environment where all medical personnel work together for the good of the patient.

SKILLS & COMPETENCIES

• Practices the WellBe mission: To help our patients lead healthier, meaningful lives by delivering the most Complete Care.
• Acts as a community resource for the patient
• Completes support during Comprehensive Initial visit when needed.
• Manage patient medical records as appropriate
• Completes Drop in visits for unengaged patients or open HEDIS gaps
• Answer patient non-clinical questions and explains the process
• Ensures all appropriate patient documentation for non-clinical summaries are in the EMR.
• Provide positive customer service and treat all patients and staff with respect
• Collaborates with the interdisciplinary team and participate in regularly scheduled team meetings as directed by supervisor.
• Complete non-invasive patient screenings, and testing.
• Ability to clearly explain POCT to geriatric patients.
• Escalate patient clinical concerns to APP, CD, CMD.
• Support APP in ongoing panel management and quality of care efforts (e.g., HEDIS)
• Utilize HEDIS tracking tools, meet and improve HEDIS STARS performance.
• Other tasks needed to accomplish team's objectives/goals

Educational/ Experience Requirements:

• High school graduate or GED

License, Certification, Registration

• MA Certification

Required Skills and Abilities:

• 2+ years of patient facing experience working for a healthcare practice or hospital
• Current BLS card for healthcare providers or willing to obtain
• EMR documentation experience preferred
• High level of professionalism
• Strong customer geriatric focus/service skills
• Strong computer skills, including Word, Excel, and PowerPoint
• Strong verbal, written, presentation, and interpersonal communication skills

Supervisory Responsibility: N/A

• Travel requirements:Travel is required locally. The role is a field-based role visiting patient homes.

Work Conditions: Ability to lift up to 20lbs. Moving lifting or transferring of patients may involve lifting of up to 50lbs as well as assist with weights of more than 100lbs. Ability to stand for extended periods. Ability to drive to patient locations (ie. home, hospital, SNF, etc). Fine motor skills/Visual acuity

The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role