Care Coordinator

Strive Health
Strive Health is built for purpose- to transform a broken kidney care system. We are fundamentally changing the lives of kidney disease patients through early identification and engagement, comprehensive coordinated care, and home-first dialysis. Strive’s model is driven by a high-touch care team that integrates with local providers and spans the entire care journey from CKD through ESRD, leveraging comparative and predictive data and analytics to identify patients at risk. Strive Health’s interventions significantly reduce the rate of emergent dialysis crash, cut inpatient utilization, and significantly improve patient outcomes and experience. Come join our journey as we create THE destination for top talent in the Healthcare community and set a new standard for how kidney care should be done.

Care Coordinator

Reporting to the RN Care Manager, a Care Coordinator works collaboratively with the care team to provide ongoing support and communication to Chronic Kidney Disease (CKD) and ESRD patients. The Care Coordinator acts as a single point-of-contact to coordinate resources along the care delivery spectrum, identify gaps, and provide proactive follow-up. The Care Coordinator is responsible for making sure the patient’s care at various locations is connected and there are no gaps in care or communication.

Essential Functions

Performs outbound calls to patients to understand their clinical needs and connect them with appropriate resources
Performs outbound calls to providers to make appointments for patients or follow up on care
Answers inbound calls from patients, providers, and other resources
Follows up with patients to ensure their needs are met and schedules future check-ins
Coordinates with clinical resources and providers to ensure smooth continuum of care for patients.
Monitors patient hospitalizations and follows up as necessary with care team members and outside resources to confirm Strive gathers all relevant patient information
Notifies patients of location and appointment times as needed
Ensures all patient records are up to date
Provides patients with education materials and sends communications to primary care physicians, nephrologists, and specialists for new enrollments/appointments
Assists with the referral process when needed
Provides excellent customer service and treats patients
Help patients and their families navigate the healthcare system and multitude of visits
Fosters a relationship with patients across their healthcare journey with a foundation of respect, honesty, empathy, no judgement and follow-through
Skilled and passionate caring for patients with complex needs
Collaborates well with all levels of a clinical team (from Medical Assistants to Physicians)
Partners closely with the Strive NP to manage all pieces of care related to resources, appointments, care transitions, and care gaps
Performs vital signs
Meet in person with internal and/or external stakeholders to facilitate team and business priorities/opportunities.
Serve patients in person and in multiple care settings (e.g., patient home, clinics) in addition to virtual visits.
Home visits as determined by business need in market.
Complete om person visits with members (in home or where convenient to patient).
Serve as liaison between multiple service providers.
Assist with enrollment in services and community resources.
Assist with completing applications for resources, paperwork for provider visits, etc.
Follow up on referrals for pharmacy, DME, home care, etc.
Assist with finding and scheduling transportation.
Deliver culturally competent care.

Minimum Qualifications

High school diploma or equivalent required
At least two (2) years of experience in a professional office environment
Internet Connectivity – Min Speeds: 3.8Mbps/3.0Mbps (up/down): Latency <60 ms

Preferred Qualifications

Customer service experience
Active Community Health Worker Certification (CHW)
Intermediate proficiency in MS Word, Excel, PowerPoint, and Outlook
Excellent verbal and written communication skills
Skilled at dealing with confidential information and/or issues using discretion and judgment
Communicates clearly, respectfully, and thoughtfully

Strive Health offers competitive compensation and benefits. An annual performance bonus, determined by company and individual performance, is available for many roles and aligned to Strive Health guidelines.

COVID Policy: As a healthcare organization, the safety of our Strivers, partners, patients, and communities is critical to our work and aligned to our first core value, Care For Others First. All new Strivers must be fully vaccinated for COVID–19 or will be required to request and obtain an approved medical or religious exemption prior to joining Strive, and otherwise comply with COVID-19 policies.

Strive Health is an equal opportunity employer and drug free workplace. At this time Strive Health is unable to provide and work visa sponsorship. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Please apply even if you feel you do not meet all qualifications. If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to [email protected]







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