Care Specialist Peer Support
Company: Upward Health
Location: Lafayette
Posted on: October 2, 2024
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Job Description:
Upward Health is an in-home, multidisciplinary medical group
providing 24/7 whole-person care. Our clinical team treats
physical, behavioral, and social health needs when and where a
patient needs help. Everyone on our team from our doctors, nurses,
and Care Specialists to our HR, Technology, and Business Services
staff are driven by a desire to improve the lives of our patients.
We are able to treat a wide range of needs - everything from
addressing poorly controlled blood sugar to combatting anxiety to
accessing medically tailored meals - because we know that health
requires care for the whole person. It's no wonder 98% of patients
report being fully satisfied with Upward Health!WHY IS THIS ROLE
CRITICAL?The Care Specialist works in patient's homes and virtually
to deliver chronic care management to high complexity patients.
This position is the first point of contact with our company for
our patients. We count on the Care Specialist to make an excellent
first impression and to be able to effectively communicate our
service offering to patients. During initial outreach the Care
Specialist informs patients about our services and helps them get
enrolled. Reaching out via phone is our top strategy for outreach
and it's important that the Care Specialist is comfortable and
confident communicating by phone. Field-based approaches are
utilized as well, and the Care Specialist should be prepared to use
whatever strategy is most effective. Once the patient is enrolled,
the Care Specialist will facilitate virtual visits from the
patient's home to our providers remotely to support our integrated
care delivery model, focused on the following goals: Promote timely
access to appropriate care; increase utilization of preventative
care; reduce emergency room utilization and hospital readmissions;
create and promote adherence to a care plan developed in
coordination with the patient, primary care provider, and
family/caregiver(s); increase patient's ability for self-management
and shared decision-making; provide medication reconciliation;
connect patients to relevant community resources, with the goal of
enhancing patient health and well-being, increasing patient
satisfaction, and reducing health care costsUpward Health provides
technology-enabled, integrated, and coordinated care delivery
services that improve outcomes and reduce costs for patients with
severe behavioral health diagnoses and co-morbid, chronic physical
conditions. We are not your typical medical practice. At Upward
Health, we see every day as an opportunity to make a difference in
our patients' lives. We could tell you about our outcomes and
patient satisfaction ratings. We could tell you about our
commitment to our mission, or you could join us and experience it
all for yourself.KEY RESPONSIBILITIES:Conduct direct outreach to
patients via phone, in-person meetings, mailings, and other
strategiesSpeak with patients about the role that Upward Health can
play in helping them improve their healthEnroll patients into
Upward Health's program and collect key data about patients during
the enrollment processCapture accurate and timely documentation in
our company's software systemMeets patients in their home or in the
community to conduct a needs assessment, including helping patients
to set health goalsFacilitate appointments between patients and
care team as neededRecord vital statistics and other health
information in electronic medical record (EMR)Monitor patients to
detect health problems.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 of health and social needs.Explain technical medical
information to patients.Collect medical information from patients,
family members, or other medical professionals.Administer basic
health care or medical treatments as directed by Upward Health care
providersOperate medical equipment (glucometer, electronic devices
for V.S. monitoring)Cultivate and support the primary care
providers with timely communication, inquiry follow-up, and
integration of information into the care plan regarding
transitions-in-care and referralBuilds rapport with Upward Health
patients utilizing motivational interviewing techniquesConduct
one-on-one extended patient calls for initial care plans, follow-up
with patients, family/caregiver(s), providers, and community
resources via secure e-mail, phone calls, and other
communicationsFacilitate patient access to appropriate medical and
specialty providersStrong organizational skills to assist patients
coordinating services across providersMakes follow-up calls and
home visits to patients per Upward Health policyCoordinates with
Clinical Care teamDocuments each patient encounter in detail per
Upward Health PoliciesPrepares reports and documents as needed or
requestedAttends regular team meetings and participate in clinical
roundsKNOWLEDGE, SKILLS & ABILITIES:Interpersonal savvy,
demonstrated by the ability to interact with and influence people
to establish trust and build strong relationshipsAbility to do home
visits and outreachExperience with usage of EMR/EHRsExperience
working in a high-volume physician practice, hospital setting, or
possibly a home care role.Strong organization skills and ability to
manage and maintain a personal scheduleAbility to establish
priorities and meet deadlinesAbility to work independently within a
virtual operating environment and as part of a teamExcellent oral
and written communication skillsAbility to exercise judgment in the
application of professional servicesActive listening skills and
genuine compassion for othersEnjoys collaboration within a team
environment and working with people of different skills and
experienceKnowledge of community resources in the local marketAble
to maintain clear professional boundaries with patients and
coworkersCommitment to represent the company with
professionalismDemonstrates cultural competency and ability to work
with diverse groups of community membersComfortable using computer
for documentation, communication, and organizing
workQUALIFICATIONS:At least 3 years of relevant work experience
High school graduate or GED requiredExperience in Chronic Care
Management model OR experience with chronically ill/elderly
patientsLong-time resident of the community with good knowledge of
the resources of this communityMust have reliable transportation
with a valid driver's license and auto liability insuranceAbility
to complete Upward Health's initial training program and ongoing
educational requirements as assignedAbility to work flexible hours,
including occasional night/weekend workUpward Health is proud to be
an equal opportunity/affirmative action employer. We are committed
to attracting, retaining, and maximizing the performance of a
diverse and inclusive workforce. This job description is a general
outline of duties performed and is not to be misconstrued as
encompassing all duties performed within the position.
PIced5f697f754-25660-35659624
Keywords: Upward Health, Baton Rouge , Care Specialist Peer Support, Other , Lafayette, Louisiana
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