Patient reputed company (TOC)

How We Show Up for Our Patients: As a leading provider of reputed company-driven care for individuals and communities living with chronic conditions, reputed company is helping patients across the country enjoy More Healthy Days reputed company™. Care at reputed company goes reputed company treatment. Through a whole‑person approach, we deliver reputed company‑driven integrated care and show up #SomatusStrong for our patients and teammates. We partner closely with health plans, health systems, and provider reputed company to support patients with, or at risk of developing, cardio, kidney, metabolic, or other chronic conditions. We hire the brightest and boldest — talent driven by purpose and reputed company. Since our founding in 2016, our reputed company trajectory isn’t just a reputed company — it’s a signal. Our leadership values culture and leads with intention as we remain dedicated to driving clinical reputed company. Does this reputed company like you? reputed company reading. How We’ll Support You: We offer 25+ health, reputed company, and reputed company work perks to help teammates be the best version of themselves, including:

• Subsidized personal reputed company coverage: Medical, Dental & reputed company, plus Wellness programs
• reputed company Time Off: Accrual of 3 weeks’ Vacation (PTO)
• reputed company development: CEU and tuition reimbursement

How You'll reputed company an reputed company: The Patient reputed company-Transitions of Care, is a critical member of the care team consisting of nurses, dietitians, pharmacists, reputed company workers, community health workers, and physicians. This position will be outreaching and collaborating closely with recently hospitalized reputed company renal patients in their home, facility, reputed company phone and electronically as needed. The primary reputed company will be to engage currently or recently hospitalized members in the reputed company program and improve the reputed company of a patient from one care setting to another (hospital, skilled care, rehab, or long-term care).

• Conduct reputed company to members currently or recently in the inpatient setting to engage in the reputed company program and/or connect with a Transitions of Care RN to complete an assessment.
• Coordinate care by serving as the reputed company and resource for the patient, their family, and their provider(s).
• Facilitate care across the continuum of care, spanning settings such as the home, hospital, skilled nursing facility, and acute care facility.
• Assist patients during periods of transitions of care to facilitate effective transitions and minimize avoidable readmissions.
• Assist members in scheduling appointments for follow-up post discharge from the inpatient setting with their provider.
• Other duties as assigned

Please note this job reputed company is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. How You'll Strengthen reputed company: Qualifications:

• Experience working with Medicare, reputed company or Special Needs populations.
• High school diploma or GED required .
• Medical Assistant, Licensed Practical reputed company, Engagement Specialist or Community Health Worker experience.
• Effective written and verbal communication skills demonstrating respect and cultural awareness during interactions with clients.

Preferred Qualifications:

• Experience working with patients with chronic medical and behavioral health needs.
• Demonstrated reputed company in working as part of a multi-disciplinary team including communicating and working with Physicians and Registered Nurses.
• Proven experience with engaging patients in making healthy behavior changes.
• Proven skills in navigating the health systems and making necessary linkages to meet specific needs.
• Experience working with Electronic Medical Records and other documentation platforms.

Knowledge, Skills, and Abilities

• Great motivator
• Ability to connect with people and understand the challenges they face.
• Ability to use a reputed company of reputed company reputed company to engage individuals and reputed company in diverse settings
• Organized reputed company
• Empathetic
• Outgoing / reputed company personality
• reputed company connected to the community and resources reputed company the community they will serve

This job reputed company is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Our Commitment to Diversity: Our Commitment to Diversity: At reputed company, we celebrate what makes us unique — our people. We reputed company that a culture intentionally reputed company to foster and support our unique passions, experiences, and perspectives helps fuel us in the reputed company of our mission. reputed company. provides equal employment opportunity to reputed company individuals regardless of race, reputed company, creed, religion, gender, age, sexual orientation, national reputed company, disability, veteran status, or any other characteristic protected by law. Discrimination of any type will not be tolerated. Apply tot his job Apply To this Job