Empowering nephrologists to transform kidney care and improve patient outcomes
Care Coordinator, MA
Location
United States
Posted
13 days ago
Salary
$45K - $52K / year
Seniority
Junior
Job Description
Care Coordinator, MA
Evergreen Nephrology
• Support CCM patient enrollment and onboarding activities. • Verify eligibility based on Evergreen and payer program guidelines. • Ensure patient consent documentation is completed prior to outreach. • Proactively maintain patient engagement regularly. • Identify inactive or non-engaged patients and escalate appropriately. • Conduct text & telephonic outreach to enrolled CCM patients weekly. • Achieve required engagement time standards aligned with Medicare CCM billing requirements. • Support achievement of required engagement time for billing compliance. • Reinforce provider-directed care plans during patient interactions. • Identify barriers to adherence including medication access, transportation, or social needs. • Document patient interactions accurately within the CCM patient management platform and EHR systems. • Track engagement time consistent with Medicare CCM billing requirements. • Maintain audit-ready documentation standards. • Ensure HIPAA and PHI compliance. • Facilitate patient access to their referring provider and clinical staff. • Support care transitions following hospitalizations or ED visits. • Coordinate referrals and follow-up appointments. • Escalate symptom concerns or medication issues to licensed clinical staff. • Utilize CCM platform and EHR systems daily. • Manage patient messaging workflows. • Collaborate with remote clinical and operational teams.
Job Requirements
- Certified Medical Assistant
- 1–3 years healthcare experience
- Chronic disease or nephrology experience is preferred.
- Strong clinical assessment, communication, and documentation skills.
- Comfortable working in two systems (EHR + CCM platform) simultaneously.
- Ability to manage a structured, metric-driven workflow with reliability.
- Intermediate skills with MS Office Suite of products including Outlook and Teams
- Able to work effectively in a primarily remote environment:
- Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended
- Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role
- Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Benefits
- Paid time off starting at 4 weeks for full-time employees
- 12 paid holidays per year
- Medical, dental, vision and life insurance, including an HSA with employer match
- Reimbursement for continuing medical education for eligible roles
- A 401(k) program where Evergreen matches up to 4% of contributions after six months of tenure
- Paid parental leave
- A robust training and development program that starts with onboarding and continues throughout your career with Evergreen Nephrology
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