Chronic Care Management Specialist

DescriptionThe Chronic Care Management Program is a Medicare program aimed at managing patients with multiple (2 or more) chronic conditions that are expected to last at least 12 months.The Chronic Care Management Specialist works with providers, patients, and insurance companies to help ensure enrolled patients receive the highest level of care, assisting them with their chronic care and preventative care needs to help reduce long-term health concerns and hospitalizations. They educate patients on the benefits of recommended preventative care services and build rapport with them to improve patient engagement, self-care management, and adherence to their individualized plan of care. They track patients' chronic care needs and work with teams within the organization to identify barriers for patients accessing care and link them to community resources. They act as a liaison, collaborating with our community partners and other healthcare organizations to ensure continuity of care and care coordination activity within the EMR.RequirementsLPN/RN license with clinical experience required.Clinical experience with an understanding of chronic disease management and knowledge of all life cycles required.Knowledge of Microsoft Excel is required.Individual must be professional, self-motivated and have strong attention to detail, communication, teamwork, customer service and computer skills.Must complete and maintain all recertification requirements for continued licensure and/or certification and retain updated copies as applicable.Must maintain Basic Life Support (BLS) certification for all life cycles.Must demonstrate excellent internal and external customer service skills.Certification as an Interpreter is preferred and ability to provide bilingual patient care is a plus.Must have a valid driver's license and reliable transportation.