We are looking to recruit a Care Coordinator to provide clinical admin support to our Multi-Disciplinary Team (MDT). The role will be varied and include coordination of clinics, imputing of clinical data and direct patient contact to encourage uptake of services. You would play an important role to proactively identify and work with people, including the frail/elderly and those with long term conditions, as well as outreach work of patients who may not be engaging with our services.
You would work closely and in partnership with the practice clinical teams, Social Prescribers, Clinical Pharmacists, and other members of the PCN multi-disciplinary teams providing coordination and navigation for patients and their carers across health and care services.
The successful candidates will display a compassionate nature, be knowledgeable about health care practices, and provide exceptional customer service. They will have excellent communication skills, and a high level of IT literacy. Familiarity with IT systems including EMIS and Docman 10 would be desirable.
Main duties of the job
Develop and implement proactive care services to help improve and maintain the health and wellbeing of our practice population. Proactively identify and work with a cohort of patients to support their personalised care requirements, using the available decision support aids.
Job responsibilities
Job Title: Care Coordinator
Responsible to: Clinical Contracts Manager
Responsible for: Working with our contracts team to develop and implement proactive care services to help improve and maintain the health and wellbeing of our practice population.
Hours of work: Part - Full time (over at least 4 days)
Salary: A competitive salary will be offered to reflect the successful candidate's experience and qualifications.
Key Duties & Responsibilities:
* To put systems in place to identify patients who are elderly, frail or who have long term health needs and support.
* To manage a virtual ward of the highest need patients, ensuring their progress and welfare is regularly checked and update patient records with details.
* To co-ordinate care plans, making sure actions are completed by health care professionals.
* To utilise population health intelligence to proactively identify other cohorts of patients, working with the clinical team to plan, implement and track interventions and report on the success of these.
* To signpost to the relevant members of the practice team and outside organisations as appropriate.
* To contact patients following hospital discharge to offer help or support and reduce the risk of loss of independence.
* To ensure systems are in place to monitor those at risk of increased hospital admissions and A&E attendances.
* To follow up on communications from out of hospital and in-patient services regarding changes in condition of patients to support the practice to respond proactively to potentially unmet needs.
* To coordinate, attend and provide administrative support for MDT meetings. To disseminate information from these meetings to other practice staff as necessary.
* To coordinate visits or arrange appointments at the practice for patients on the caseload.
* To manage monthly recall searches and ensure patients are attending their Long-Term condition appointments, following up on those not attending.
* To maintain accurate and up to date records of patient contacts, entering notes onto EMIS.
* Co-ordinate and liaise with patient services manager on promoting National and local Health campaigns.
* Use language line to communicate with patients who may otherwise not engage with our services.
* Completion of 2 day accredited training course as defined by Hedena.
Person Specification
Experience
* Experience of working in the NHS with knowledge and understanding of the roles of the NHS organisation and of the primary care sector.
* Experience of successfully developing and implementing projects.
* Experience of working in a multi-site environment.
Skills
* Highly literate and numerate with an excellent eye for detail.
* Possess excellent communication skills both verbal and written, and demonstrate the ability to communicate complex information transparently and effectively.
* Ability to communicate complex and sensitive information effectively with people at all levels by telephone, email, video conference and face to face.
* Able to demonstrate a high level of IT skills (Microsoft Word, Excel, data).
* To be able to demonstrate being adaptive and comfortable with change.
* Evidence of strong team working skills.
* Excellent organisation and planning skills, able to meet changing priorities and time frames.
* Able to cope with unexpected situations and provide solutions to problems.
* Evidence of ability to complete tasks to a high standard with minimal supervision.
* Flexible and adaptable and able to demonstrate the ability to make good decisions under pressure and deliver on deadlines.
* Required to work collaboratively and build good relationships with others, possessing excellent negotiation skills.
* Ability to cope under pressure with a considerable and varied workload.
* Good practical and conceptual knowledge of healthcare improvement methods and practices.
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
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