[Hiring] Community Health Coordinator @Lucet

Role Description

The Community Health Coordinator serves as a non-clinical advocate who connects patients to care, resources, and education while coordinating with care teams to improve health outcomes and support whole-person wellbeing.

Care Coordination & Team Collaboration

• Coordinate patient care with RN Manager, Medical Assistant, and interdisciplinary teams to ensure timely interventions and aligned care plans.
• Conduct outreach (calls, visits) and escalate clinical concerns to licensed staff while supporting care planning through case conferences and dual visits.

Resource Navigation & Social Support

• Assess social determinants of health and connect patients to community resources such as housing, transportation, food, and financial assistance.
• Evaluate living conditions and identify risks, escalating concerns and maintaining/updating resource networks to support patient needs.

Patient Engagement, Education & Program Support

• Educate and guide patients on care navigation, lifestyle changes, and self-management goals using culturally appropriate approaches.
• Maintain accurate documentation, complete follow-up tasks, and support quality initiatives to ensure effective care delivery and patient engagement.

Qualifications

• High school diploma or GED
• Computer literacy and ability to use an electronic health record effectively.
• Ability to use electronic medical record (EMR) systems.
• Able to troubleshoot basic connectivity and device issues in the field.
• Valid proof of sufficient car insurance coverage for the state that appointments are scheduled to be completed in with access to reliable transportation.
• Valid and active driver’s license for a minimum of 3 years without restrictions, and minimum of 7 years with no DUIs or other felony driving convictions.
• Ability to work evenings and weekends if required.
• Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.

Requirements

• Strong advocacy skills with demonstrated ability to champion patient needs.
• Strong organizational and time management skills.
• Comfortable using company‑issued technology, secure messaging, and telehealth applications for virtual visits.

Working Conditions

• High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.
• Frequent use of computer and phone systems.
• Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
• Work is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.
• A quiet workspace with minimal background noise for calls.
• Ability to lift and carry up to 20 lb.
• Work is performed in patient homes or facilities and may involve exposure to varied conditions.
• Regular travel to patient homes, provider facilities, or community locations. Employees may be exposed to varying weather conditions, road hazards, and unfamiliar environments.