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081290 InstED-Operations

Position Summary:

Our healthcare system is under tremendous pressure as we face legislative and budget challenges, ever rising costs, and a lack of capacity and access to quality care. These challenging circumstances have emphasized the need for innovative care delivery models that go beyond the traditional methods of caring for patients. We should no longer accept the fact that millions of people do not have access to proper care and visit Emergency Departments because they have no alternatives. The poor patient experience, the sub-optimal care, and the estimated $8.3B spent on unnecessary ED visits each year, make it extremely clear that something needs to be done. instED was founded to help solve these very problems. We strive to eliminate unnecessary and avoidable visits to Emergency Departments and the inpatient hospital admissions that often follow, by offering quality urgent care services in the comfort of the patient’s home. Come join this early-stage, innovative, growing company and team, and help deliver healthcare of the 21st century!

Under the direction of the Chief Operating Officer, the Clinical Support Specialist (CSS) will ensure that instED seamlessly integrates into a patient’s longitudinal care and does not fragment their care in any way. The CSS will facilitate effective post-visit care and support for instED patients, whether it is to provide basic health education information, ensure they were able to fill prescriptions or secure transportation, make appointments with PCP or other providers, navigate to additional support from their health plan (e.g., care managers, benefit or network information), or connect with community supports to address social determinants of health challenges that may impact their health outcomes and result in additional acute care episodes. instED is not only accountable for the patient’s care on the day of the visit, but we want to fulfill our responsibility to link the patient to crucial follow-up care, as well as any non-clinical support they may need to secure that follow-up care.

Supervision Exercised:

• No, this position does not have direct reports.

Essential Duties & Responsibilities and Working Conditions

• Field lab-related questions from several different lab vendors, patients, and providers

• Respond to patient calls regarding test results, prescriptions, and other non-urgent clinical matters

• Monitor and respond to Clinical Support email inbox and escalate to nursing team, as indicated

• Cross-train as a Mobile Health Coordinator to conduct intakes and process requests for referrals

• Review, validate and process medical records requests from patients in a timely manner

• Ensure instED visit notes are consistently sent to patients’ PCP and other pertinent care providers and connect PCPs to clinicians when necessary

• Conduct follow-up phone calls to patients after an instED visit, as directed by the nurses and providers

• Manage the administrative aspects of the Athena clinical inbox

• Follow-up on safety concerns reported by mobile health provider workforce

• Maintains knowledge of community resources in MA

• Initiate and facilitate patient referrals to various community organizations and primary care providers in their health plans’ networks

• Provide ongoing daily administrative support to the Clinical Resource Center nurses as directed

• Coordinate follow-up care with external care teams, as directed by the Virtual Medical Control providers

• Transfer/escalate issues to licensed independent practitioners as appropriate

• Document and report on successful and unsuccessful patient outreach

• Participate in quality and process improvement initiatives

Required Education (must have):

• High School Diploma required

• Completion of a Medical Assistant, Community Health Worker, or similar training program

Desired Education (nice to have):

• Bachelor’s degree

Desired Licensing (nice to have):

• Certified Medical Assistant

Required Experience (must have):

• 2+ years working in a health care setting as a Medical Assistant, Community Health Worker, or similar position

Desired Experience (nice to have):

• Remote work

Required Knowledge, Skills & Abilities (must have):

• Ability to effectively work with patients, colleagues, and vendors that are diverse, including but not limited to race, ethnicity, color, gender identity, age, socio-economic status, disability

• Proficient knowledge of medical terminology, including health insurance terms and concepts

• Proficiency in Microsoft Office Suite – Outlook, Word, Excel, Teams

• Competence working within an electronic medical record, athenahealth

• Ability to maintain strict confidentiality handling sensitive medical information

• Experienced providing culturally responsive care to a diverse population

• Ability to provide compassionate customer service

• Experience addressing social determinants of health

• Ability to recognize and escalate urgent or emergent issues timely

• Familiarity with preferred methods of communication and telecommunications guidelines

Required Language (must have):

• English

Desired Knowledge, Skills, Abilities & Language (nice to have):

• Bilingual/bicultural Spanish

• Motivational interviewing

• Experience navigating social and community services

• Data analysis and reporting

• Experience reviewing and responding to ADT data from health plans

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.