Transitional Care Specialist - Medical Assistant Or Lpn

We’re a physician-led, patient-centric network committed to simplifying the complexities of health care and bringing a more connected kind of care.

And now we’re proud to say we’re part of the VillageMD family.

VillageMD, through its operating companies, provides high-quality, accessible health care services for individuals and communities across the United States, with primary, multispecialty, and urgent care providers serving patients in traditional practice settings, in patients’ homes and online appointments.

Committed to serving all patients and working with all payers, VillageMD consistently innovates value-based care, bringing integrated applications, population insights and staffing expertise to its owned and affiliated practices, ensuring high-quality care, better patient outcomes and a reduction in the total cost of care. Through Village Medical, Village Medical at Home, Summit Health, CityMD, Starling Physicians, Westmed, and other practices, VillageMD serves millions of patients throughout their lives, wherever and whenever they need care. Its dedicated workforce of more than 20,000 operates from 770 practice locations and 26 markets.

Why become a Villager?

When you work at VillageMD, or a VillageMD operating company, you are part of a compassionate community of people who work hard every day to make health care better for all. What makes us different is our village of supportive and inspiring peers who want a meaningful career with impact. The work we do is changing the lives of our patients, our communities, and each other. Together, we are creating better outcomes for all.

We’re reimagining health care with a primary care-led, value-based care model. Here, you will be part of a team delivering the care we want to see in the world. It is what drives us to knock down old barriers in health care because every patient, every person and every community deserves better care. Here, you will be at the center of our mission. Your voice will be heard, and you will feel empowered to do what’s best and right for our patients, communities, and each other. To learn more about VillageMD visit our corporate site VillageMD.com.

Job Description

*Remote Role*

Integral to our Care Management team, the Transitional Care Specialistsis accountable for collaborating with the care team to consistently communicate and document high risk patient profiles to provider and practice care teams. As a new member of VillageMD, you’ll work closely with our multidisciplinary care team to connect the dots of collaborative patient care while incorporating patients’ personal health and lifestyle goals.

How you can make a difference

• Outreach and engage patients whom are high risk, post-discharge, and/or requiring additional care management support, ensuring they have Primary Care Provider (PCP) follow up appointments scheduled and all care gaps are closed
• Collaborate with care team members and external vendors to support patient care (ie: receipt of durable medical equipment (DME) and home health services
• Request medical records from a variety of physicians and healthcare systems enabling the continuity of care for both PCPs and members of the interdisciplinary care team
• Outreach, screen and escalate patients to nursing and social work team members based on the unique needs of patients
• Assist nursing and social work team members with patient follow up, proving tools and resources at their direction
• Monitor stable patient populations at the direction of nursing and social work team members
• Address open care gaps with patients through collaborative relationships with patients, ensuring supporting adequate documentation is available with the patient’s medical record
• Coordinate with local community resources as needed to support both the physical and psychosocial needs of patients
• Collaborate with multi-disciplinary team members to provide best in class patient care and improved outcomes
• Participate in special initiatives at the direction of market leaders

Skills for success

• Achieving objectives by effectively managing multiple tasks at one time
• Maintaining an organized and systematic workflow that results in goals being met
• Flexibility in an ambiguous and dynamic environment, maintaining a positive and “can do” attitude
• A passion for changing the way healthcare is experienced for complex and/or disadvantaged patients and communities
• Demonstrated strength-based approach to collaborative problem solving
• Effective engagement of diverse populations (age, ethnic groups, socio-economic levels, etc.) with exhibited cultural sensitivity
• A willingness to learn on your own and take initiative
• Demonstrated honesty and following through on commitments
• The ability to problem-solve on the spot and identify issues that need escalated
• A low ego and humility; an ability to gain trust through good communication

Experience to drive change

• 3+ years of experience in a medical office or health care setting
• 2+ years working as a, Licensed Practical Nurse LPN, or state equivalent, Medical Assistant (MA), Pharmacy Tech or Community Health Worker (CHW) preferred
• Comfort with technology including the Microsoft suite of products
• Prior experience using electronic health record including data capture, data mining and reporting

Total Rewards at VillageMD

Our team members are essential to our mission to reshape healthcare through the power of connection. VillageMD highly values the critical role that health and wellness play in the lives of our team members and their families. Participation in VillageMD’s benefit platform includes Medical, Dental, Life, Disability, Vision, FSA coverages and a 401k savings plan.

Equal Opportunity Employer

Our Company provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Safety Disclaimer

Our Company cares about the safety of our employees and applicants. Our Company does not use chat rooms for job searches or communications. Our Company will never request personal information via informal chat platforms or unsecure email. Our Company will never ask for money or an exchange of money, banking or other personal information prior to the in-person interview. Be aware of potential scams while job seeking. Interviews are conducted at select Our Company locations during regular business hours only. For information on job scams, visit, https://www.consumer.ftc.gov/JobScams or file a complaint at https://www.ftccomplaintassistant.gov/.

Job Type: Full-time

Pay: $40,191.07 - $48,402.15 per year

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Professional development assistance
• Vision insurance

Medical specialties:

• Primary Care

Schedule:

• 8 hour shift
• Monday to Friday

Location:

• Phoenix, AZ (Required)

Work Location: Remote