Job description

Job description

The Health Coach works closely with the clinical and administrative leadership to provide outreach, education, counseling, and follow up for patients identified with chronic disease or those requiring preventive health maintenance. The Health Educator is instrumental in improving health outcomes.
* Minimum Education High School Diploma, Bachelors preferred
* Minimum Experience/Requirements: Experience in health related field with direct patient
contact/customer service. Excel, Word – ability to create tracking documents Experience in

EMR preferred
* Required License, Registration, Certification: A
* Preferred Qualifications: Excellent customer service skills. Ability to work with various
departments within the hospital system as well as external resources.
* Provides education and counseling for individuals and groups with chronic disease as well
as for preventive health under the direction of nursing, providers, site leadership and
ambulatory administration
* Serves as the point of contact in transition of patient care from ED or hospital discharge
back to primary care
* Documents education in the patients EMR.
* Performs the screening for provider review of behavioral health and substance use
problems, including depression, alcohol abuse, substance abuse and smoking status using
validated tools within the emr.
* Alerts nursing or provider about patient issues that may be identified during sessions via
the EMR or in person documenting such.
* Proactively performs outreach to patient populations
* Identifies patients with gaps in care
* In collaboration with the health care team, identify patients that require follow up either
regarding chronic health maintenance, preventive, no show or other, contact the patients
and document the outcome of this intervention in the EMR.
* Schedule appointments for patients based on outreach activity or follow up interventions.
* Tracks and follows up on test results to ensure patient and caregiver take appropriate next
steps as needed
* Tracks and follows up on test results to ensure patient and caregiver take appropriate next
steps as needed
* Attend daily huddles with the health care team.
* Identify barriers to care and direct the patient to the appropriate source for assistance.
* Collect and maintain statistics regarding interventions with the patient and work with the
appropriate source to create meaningful reports.
* Report health interventions and trends as required.
* Perform community health outreach as directed either to specific patients or at health
outreach events
* Demonstrates excellent customer service, professionalism, sensitivity towards patients and
coworkers.
* Work on special projects or health initiatives as assigned.
* Works with DSRIP team and PI to impact positive outcomes
* Excellent communication skills, able to effectively engage patients
* Works independently with guidelines provided and reports to Nurse manager. Acts as an
integral member of the health team
* Report on and works to continuously improve processes in conjunction with the
ambulatory health team
* Acts as a liaisons and patient advocate to promote positive patient outcomes
* Recognizes the need for considerate team work and facilitates the concept with others

Position Requirements
This position requires a minimum formal education of High School Diploma or equivalent and a
minimum of 3 years job-related experience.
Desired (not required) criteria include: Bachelor degree preferred

Health maintenance and outreach experience. Experience with population health management.

Job Type: Full-time

Location:

• Brooklyn, NY (Required)

Shift : Monday - Friday (8:00 A.M. - 4:00 P.M.)

Job Type: Full-time

Pay: $75,000.00 per year

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Brooklyn, NY 11237: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person

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