Care Specialist Position Available In Pearl River, Mississippi

Job Description:

CARE SPECIALIST

Are you a dedicated individual with a passionfor providing quality care and making a positive impact in thelives of others? If you possess a unique blend of skills andattributes, including critical thinking, resilience, and theability to thrive in unstructured environments, we invite you toconsider joining our team as a Care Specialist. As a CareSpecialist, you will play a crucial role in our organization,working in a dynamic and ever-changing field. Your responsibilitieswill extend beyond the ordinary, and we are looking for someone whopossesses the tenacity, resilience, and perseverance to excel inchallenging situations. Your role will require you to be aself-starter, someone who not only understands the art ofprioritization but is also keen to understand the “why” behind whatwe do. You’ll engage with individuals from diverse backgrounds andoften with complex needs, so the ability to work with difficultpeople and always be willing to help is a must. You don’t just say”no”; you ask “how” and seek the “why.” Your awareness of communityand diversity will be vital in ensuring that you provide culturallysensitive and inclusive care. Organizational skills,responsiveness, and flexibility are key as you navigate theever-evolving landscape of healthcare. Your self-motivation andability to pivot, serving as a change agent when necessary, will behighly valued. You have an outcome-oriented approach and arewilling to learn, adapting to new challenges and opportunities withenthusiasm. Criticism doesn’t deter you; you take it as a chancefor self-improvement and growth. Self-awareness is your ally, andyou thrive as an independent problem solver. Your passion forpeople is the driving force behind your commitment to deliveringhigh-quality care. If you possess these qualities and are ready toembrace a role that demands dedication, adaptability, and a deepdesire to make a positive impact, we encourage you to explore thepossibilities of becoming a Care Specialist within ourorganization. Join us in our mission to provide exceptional careand support to those who need it most. Who is Upward Health UpwardHealth is an in-home, multidisciplinary medical group providing24/7 whole-person care. Our clinical team treats physical,behavioral, and social health needs when and where a patient needshelp. Everyone on our team from our providers, nurses, and CareSpecialists to our HR, Technology, and Business Services staff aredriven by a desire to improve the lives of our patients. We areable to treat a wide range of needs – everything from addressingpoorly controlled blood sugar to combatting anxiety to accessingmedically tailored meals – because we know that health requirescare for the whole person. I t’s no wonder 98% of patients reportbeing fully satisfied with Upward Health! What you will do. TheCare Specialist works in patient’s homes and community 90% of thetime and virtually the other 10% to deliver chronic care managementto high complexity patients. During initial outreach the CareSpecialist informs patients about our services and helps them getenrolled. Reaching out via phone is our top strategy for outreachand it’s important that the Care Specialist is comfortable andconfident communicating by phone. Field-based approaches areutilized as well, and the Care Specialist should be prepared to usewhatever strategy is most effective. Once the patient is enrolled,the Care Specialist will facilitate virtual visits from thepatient’s home to our providers remotely to support our integratedcare delivery model, focused on the following goals: Promote timelyaccess to appropriate care; increase utilization of preventativecare; reduce emergency room utilization and hospital readmissions;create and promote adherence to a care plan developed incoordination with the patient, primary care provider, andfamily/caregiver(s); increase patient’s ability for self-managementand shared decision-making; provide medication reconciliation;connect patients to relevant community resources, with the goal ofenhancing patient health and well-being, increasing patientsatisfaction, and reducing health care costs

KEY RESPONSIBILITIES

Conduct direct outreach to patients via phone, in-person, mailings,and other strategies including cold calling and unscheduled doorknocks. Enroll patients into Upward Health’s program and collectkey data about patients during the enrollment process throughcontinuous and on-going phone and in-person interactions. Meetspatients in their home or in the community to conduct a needsassessment, including helping patients to set health goals.

Facilitate in-home provider appointments and coordinate carebetween patients and care team as needed. Ensuring that all of yourassigned patients have an initial provider visit and follow upvisits scheduled. Support your patients in meeting their healthcaregoals as it relates to Quality measures. Work within aninterdisciplinary team to support the team’s effort in meetingmarket and/or organizational goals. Obtain and record vital signsand other health information in electronic medical record (EMR)Analyze patient data to determine patient needs or treatment goals.

Assess physical conditions of patients to aid in diagnosis,treatment; and/or need for additional referrals in support ofhealth and social needs. Explain technical medical information toeducate the patients. Cultivate and support the primary careproviders with timely communication, inquiry follow-up, andintegration of information into the care plan regardingtransitions-in-care and referral. Builds rapport with Upward Healthpatients utilizing motivational interviewing techniques. Conductone-on-one extended in-person patient appointments. Makes follow-upcalls and home visits to patients per Upward Health policy.

Documents each patient encounter with accuracy and precision.

Prepares reports and documents as needed or requested. Attendsregular daily huddle, team meetings and participates in clinicalrounds. Other duties as needed.

KNOWLEDGE, SKILLS & ABILITIES

Strong critical thinking skills for assessing patient needs andtreatment goals. Self-starter with the ability to workindependently in an unstructured environment. Interpersonal savvy,demonstrated by the ability to interact with and influence peopleto establish trust and build strong relationships. Familiar withconcepts like Motivational interviewing, trauma informed care andcare coordination. Ability to complete unscheduled home visits,completed cold-calls and outreach. Strong organization skills andability to manage and maintain a personal schedule. Proficient intime management and the ability to prioritize tasks effectively.

Ability to work independently within a field-based environment andas part of a team. Excellent communication and motivationalinterviewing skills to engage with difficult patients and theability to explain technical medical information. Proficient in theaccurate and timely documentation of patient information inmultiple electronic medical record (EMR) systems to ensure seamlesscontinuity of care and data integrity.

QUALIFICATIONS

At least 2years of relevant work experience as a Community Health Worker,Peer Support Specialist, Medical Assistant, or similar role Highschool graduate or GED required. A valid driver’s license and autoliability insurance. Reliable transportation and the ability totravel within your assigned territory or other as needed to supportthe patient needs plan and training requirements. Experience inChronic Care Management model OR experience with chronicallyill/elderly patients. Long-time resident of the community with goodknowledge of the resources of this community. Ability to completeUpward Health’s initial training program and ongoing educationalrequirements as assigned, both virtually and in-person.

Technologically savvy with basic computer skills, including abilityto type. Multi-lingual capabilities preferred, but not required.

Prior Home Care experience a plus Upward Health is proud to be anequal opportunity/affirmative action employer. We are committed toattracting, retaining, and maximizing the performance of a diverseand inclusive workforce. This job description is a general outlineof duties performed and is not to be misconstrued as encompassingall duties performed within the position.

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