Population Health Engagement Coordinator - York - Days

York, PA | Professional | Tracking Code: 64769

Job Description:

Is responsible for outreaching and engaging to assigned populations to support the connection to social service agencies and mitigation of social determinants of need barriers, including but not limited to: long-term care support, horizon planning, and support of discharge patients with social needs. Based on a algorithms and department protocols, is responsible for identifying candidates who have complex or ongoing needs and appropriately referring them to care management programs/resources. Provides administrative support for the centralized care management unit and works under the guidance and direction of the leadership of Population Health to provide social work support to the Customer’s population.

 

Duties and Responsibilities

  1. Assists with patient engagement and outreach, care coordination services, and navigation of the health care system.
  2. Utilizes population management data and resources to identify at risk patients and facilitate appropriate support and resources.
  3. Provides patient outreach and engagement assessment related to social determinants of health and removes barriers to success.
  4. Facilitates patient engagement with their medical home and regional care management team, assists with access to and navigation of the health care system.
  5. Appropriately documents assessments and interventions in the patient's electronic medical record.
  6. Participates in care team meetings, performance improvement and patient and customer experience initiatives.
  7. Reports issues and system barriers to efficient and effective care management.
  8. Carries a case load for patients recently discharged from a WellSpan facility with ongoing social support needs who are not assigned to a member of the Ambulatory Care Management team.
  9. Acts as social work resource within the centralized population health care management unit.
  10. Assists with onboarding of new Social Worker and Community Health Worker team members
 

Qualifications

  • Minimum Experience:
    • 3 - 5 years
  • Minimum Education:
    • Bachelor's Degree Social Work
  • Preferred Field Of Expertise:
    • Population health, case management, or social work specialty
  • Required Certification:
    • CCM obtained within 2 years of hire
Michelle Dermes
Michelle Dermes
Sr. Talent Acquisition Consultant
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Why WellSpan Health?

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization comprises a multispecialty medical group of more than 1,600 physicians and advanced practice providers, a regional behavioral health organization, a home care organization, eight respected hospitals, more than 20,000 employees and 200 patient care locations. WellSpan is a charitable, mission-driven organization committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Employment Benefits

  • Sign-on incentives for new employees (click here for details)
  • Medical, dental and vision insurance
  • Life and accidental death insurance
  • Supplemental life insurance
  • Retirement savings plan
  • Paid time off (PTO)
  • PTO bridging
  • Short-term disability
  • Educational assistance
  • Forgivable loan
  • Flexible spending
  • Credit union
  • Employee recreational activities
  • Childcare
  • Complimentary medicine discounts

Diversity & Inclusion

Welcome. Respect. Value.

Wellspan Health believes that diversity includes all the human characteristics that make each of us similar as well as different. We strive to make every person feel welcomed, respected, and valued while creating a safe and inclusive environment where we all have the individual freedom to express our uniqueness in a respectful manner.

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)