POPULATION HEALTH PROGRAM COORDINATOR
Auto req IDAdhere to the population-based, consultative role of the primary care behavioral health model. Provide flexible consultation services within the emergency department(ED) as needed per the request of providers within the ED.Assist providers and case management staff in assessing mental health concerns and psychosocial problems. Conduct functional assessments to determine patient social situation, physical environment, mental health, substance use, expressed trauma, and other behavioral concerns and economic status. Work with staff to in identifying and the development of behavioral change plans that are devised with input from patient to assist with reentry to the community. Perform targeted interventions to assist patients with connection to primary care providers and other health care resources in order to help patients meet their medical, psycho-social and other needs. Provide outreach and targeted interventions to patients who have screened positive for behavioral health concerns with need of additional follow-up.Provide individual targeted treatment to address barriers and identified concerns on positive screenings. Provide targeted counseling to address identified concerns.Assure the efficient, effective and appropriate flow of necessary patient and care information to the appropriate providers.Identify ongoing patient barriers that may interfere with success and assist patient with addressing those concerns.Providing support that encourages appropriate treatment recommendations.Care Coordination and Care Management
5574 POPULATION HEALTH PROGRAM COORDINATOR
Assessment and Intervention:
:Facilitate interdisciplinary communication to include specialists, PCP, psychiatrist and other key providers.Provide on-site and telephonic outreach to provide relevant information regarding prior treatment history, diagnoses and patient care components both internally and externally to ensure that services provided are sensitive to the needs of individual patients and take into account ethnic and cultural backgrounds. Participate in rounds with ED staff to assist in identifying patient needs and begin the discharge collaboration process in an effort to provide immediate and impactful care within the emergency department. Interface with key providers (e.g. discharge planners, social workers, physicians, psychiatrist etc.) within the hospital, primary care practices, public health and social service departments, as well as mental health agencies and other community resources to assure that patients are linked to and engaged in services. Facilitate transitions in care by collaborating with care management team and assist with engaging in appropriate services. Assist patients to re-connect with existing MH/SA provider and connect patients to Alliance Behavioral Healthcare Customer Service Call Center if they don't an existing provider.Alert MH/SA providers when patients have entered ED to ensure that an immediate follow up appointment occurs. Collect, analyze, and report data for resource utilization by completing a spreadsheet with information about the patients served. Collaborate with other providers and case managers serving the patient to ensure continuity of care and avoid duplication of services.Provide coordination of care between medical health and mental health providers. Collaborating patients with mental health/substance abuse diagnoses and develops strategies to meet the needs of these patients. Works closely with NPCC care management/Alliance care coordination staff to connect these patients to services with the goal of a reduction in hospital/ED utilization.Electronically documents all activity in Maestro, and other documentation systems relevant to the position. In addition, provides any necessary follow-up interventions that may be required. Electronically documents all activity in Maestro, CMIS, ALPHA and other documentation systems relevant to the position. In addition, provides any necessary follow-up interventions that may be required. Location
POPULATION HEALTH PROGRAM COORDINATORShift
First/DayJob Family Level
F2Full Time / Part Time
FULL TIMERegular / Temporary
Regular Department Name
NPCC MEDICAIDMinimum Qualifications
Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
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Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.Education
Work requires a bachelor's degree. Prefer degree in a clinical or business-related field such as Nursing, Social Work, Therapy, Business, allied health, or community health related fields.Experience
Work requires the ability to plan and administer programs and direct program activities and staff within a specific functional area, acquired through four years of related experience. Preference:
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