Palm Beach Accountable Care Organization
Clinical Population Health Care Coordinator
Palm Beach Accountable Care Organization, Florida, New York, United States
Clinical Population Health Care Coordinator
Join to apply for the
Clinical Population Health Care Coordinator
role at
Palm Beach Accountable Care Organization .
Pay Range This range is provided by Palm Beach Accountable Care Organization. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range:
$70,000.00/yr - $80,000.00/yr
Job Description The Clinical Population Health Care Coordinator serves as a patient advocate and liaison within the healthcare team, ensuring patients receive coordinated, efficient, and compassionate care. This role focuses on proactive patient outreach, timely care coordination, and patient/provider support to reduce hospital admissions, improve health outcomes, and ensure smooth transitions of care across settings.
Candidate must possess leadership qualities, be highly organized, self‑motivated, able to work well with others and confident with EMR/computers/data. Great benefits include health insurance, PTO, Paid Holidays, 401K, and more.
Clinical certifications:
RN, LPN, APRN or PA license required.
Responsibilities Patient Engagement and Post-Discharge Support
Serve as the primary contact for patients requiring additional care coordination and navigation services.
Educate patients and families about care plans, procedures, and available community resources.
Care Coordination
Foster and maintain relationships with local hospitals and ED staff to support ACO initiatives.
Collaborate with hospital leadership, physicians, case managers, and ED staff on ACO initiatives and proper coordination of transitional care management and post‑discharge care planning between multiple levels of care and interdisciplinary teams.
Educate physicians, hospitals, and ED staff on data that pertains to ACO hospitalists and ACO patients.
Facilitate care for high‑risk members utilizing appropriate physician services (primary / specialist), care transitions and coordination of community support services.
Utilize tools and resources to manage discharge alerts, monitor care transitions, and document all patient outreach and outcomes.
Monitor and follow up on patient care plans, ensuring compliance and addressing any barriers.
Clinical Initiatives
Develop, implement, and evaluate clinical initiatives based on evidence‑based guidelines to improve patient care.
Monitor outcomes and analyze data to measure the effectiveness of clinical initiatives.
Work collaboratively with providers, staff and other health care professionals utilizing the latest technology to provide improved quality of care while reducing unnecessary tests, procedures, and overall costs.
Educate ACO providers and staff on ACO data and guidelines.
Develop strategies and tools to enhance accuracy, efficiency, and engagement of communication with physician members and office staff.
Develop a team approach by working collaboratively with the primary care provider and other members of the healthcare team to ensure coordination of services.
Provide on‑site consultation, training and education to primary care providers and office staff.
Patient Advocacy
Advocate for patient needs within the healthcare system, addressing any gaps in care.
Promote patient understanding and self‑management of their health conditions.
Collaborate with providers to identify and elevate complex or high‑risk patients requiring additional support or interventions.
Qualifications / Experience
RN, LPN, APRN or PA license required.
2+ years’ experience in a healthcare setting.
Knowledge of healthcare delivery systems in the out‑patient office, hospital, ED, or post‑acute settings.
Strong organizational, leadership, project management and communication skills.
Ability to work independently and as part of a multidisciplinary team.
Proficiency in EMR and Microsoft Office.
Advanced skills with Spreadsheets / Report Writing / PowerPoint / Word / Excel.
Some after‑hours responsibility.
Unrestricted driver’s license.
Competencies
Software: MS Office (Word, Excel, PowerPoint, etc.), EHR systems, SQL, online portals, population health database.
Organization/Planning Skills.
Problem Solving/Innovative.
Autonomous/Independent.
Knowledge of medical terminology.
Systems/Workflows/General IT.
Detail Oriented.
Dependable/Adaptable/Flexible.
Assertive/Reliable.
High stress tolerance.
Abide by all HIPAA, confidentiality and privacy laws.
Oral Communication — Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions.
Safety and Security — Uses equipment and materials properly.
Attendance/Punctuality — Is consistently at work and on time.
Knowledge of legal and ethical considerations related to patient information.
Physical Demands While performing the duties of this job, the employee will have a combination of standing, sitting, bending, and reaching. May work at a computer monitor for prolonged periods. The employee may lift and/or move up to 10 pounds.
Job Type Full‑time
Seniority level
Entry level
Employment type
Full‑time
Job function
Health Care Provider
Hospitals and Health Care
#J-18808-Ljbffr
Clinical Population Health Care Coordinator
role at
Palm Beach Accountable Care Organization .
Pay Range This range is provided by Palm Beach Accountable Care Organization. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range:
$70,000.00/yr - $80,000.00/yr
Job Description The Clinical Population Health Care Coordinator serves as a patient advocate and liaison within the healthcare team, ensuring patients receive coordinated, efficient, and compassionate care. This role focuses on proactive patient outreach, timely care coordination, and patient/provider support to reduce hospital admissions, improve health outcomes, and ensure smooth transitions of care across settings.
Candidate must possess leadership qualities, be highly organized, self‑motivated, able to work well with others and confident with EMR/computers/data. Great benefits include health insurance, PTO, Paid Holidays, 401K, and more.
Clinical certifications:
RN, LPN, APRN or PA license required.
Responsibilities Patient Engagement and Post-Discharge Support
Serve as the primary contact for patients requiring additional care coordination and navigation services.
Educate patients and families about care plans, procedures, and available community resources.
Care Coordination
Foster and maintain relationships with local hospitals and ED staff to support ACO initiatives.
Collaborate with hospital leadership, physicians, case managers, and ED staff on ACO initiatives and proper coordination of transitional care management and post‑discharge care planning between multiple levels of care and interdisciplinary teams.
Educate physicians, hospitals, and ED staff on data that pertains to ACO hospitalists and ACO patients.
Facilitate care for high‑risk members utilizing appropriate physician services (primary / specialist), care transitions and coordination of community support services.
Utilize tools and resources to manage discharge alerts, monitor care transitions, and document all patient outreach and outcomes.
Monitor and follow up on patient care plans, ensuring compliance and addressing any barriers.
Clinical Initiatives
Develop, implement, and evaluate clinical initiatives based on evidence‑based guidelines to improve patient care.
Monitor outcomes and analyze data to measure the effectiveness of clinical initiatives.
Work collaboratively with providers, staff and other health care professionals utilizing the latest technology to provide improved quality of care while reducing unnecessary tests, procedures, and overall costs.
Educate ACO providers and staff on ACO data and guidelines.
Develop strategies and tools to enhance accuracy, efficiency, and engagement of communication with physician members and office staff.
Develop a team approach by working collaboratively with the primary care provider and other members of the healthcare team to ensure coordination of services.
Provide on‑site consultation, training and education to primary care providers and office staff.
Patient Advocacy
Advocate for patient needs within the healthcare system, addressing any gaps in care.
Promote patient understanding and self‑management of their health conditions.
Collaborate with providers to identify and elevate complex or high‑risk patients requiring additional support or interventions.
Qualifications / Experience
RN, LPN, APRN or PA license required.
2+ years’ experience in a healthcare setting.
Knowledge of healthcare delivery systems in the out‑patient office, hospital, ED, or post‑acute settings.
Strong organizational, leadership, project management and communication skills.
Ability to work independently and as part of a multidisciplinary team.
Proficiency in EMR and Microsoft Office.
Advanced skills with Spreadsheets / Report Writing / PowerPoint / Word / Excel.
Some after‑hours responsibility.
Unrestricted driver’s license.
Competencies
Software: MS Office (Word, Excel, PowerPoint, etc.), EHR systems, SQL, online portals, population health database.
Organization/Planning Skills.
Problem Solving/Innovative.
Autonomous/Independent.
Knowledge of medical terminology.
Systems/Workflows/General IT.
Detail Oriented.
Dependable/Adaptable/Flexible.
Assertive/Reliable.
High stress tolerance.
Abide by all HIPAA, confidentiality and privacy laws.
Oral Communication — Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions.
Safety and Security — Uses equipment and materials properly.
Attendance/Punctuality — Is consistently at work and on time.
Knowledge of legal and ethical considerations related to patient information.
Physical Demands While performing the duties of this job, the employee will have a combination of standing, sitting, bending, and reaching. May work at a computer monitor for prolonged periods. The employee may lift and/or move up to 10 pounds.
Job Type Full‑time
Seniority level
Entry level
Employment type
Full‑time
Job function
Health Care Provider
Hospitals and Health Care
#J-18808-Ljbffr