Care Coordinator

POSITION OVERVIEW

Harbor Health is seeking a Care Coordinator to support our integrated care delivery model. This role is essential to our care management team, working collaboratively with providers and multidisciplinary teams to ensure high-risk members receive coordinated, comprehensive care. The Care Coordinator will engage members in their healthcare journey, close care gaps, and facilitate seamless communication across our payvider platform.

• Proactively outreach and engage high-risk members, post-discharge members, and those requiring additional care management support
• Schedule Primary Care Provider (PCP) follow-up appointments and ensure all care gaps are closed
• Collaborate with care team members and external vendors to coordinate member care, including durable medical equipment (DME) and home health services
• Request and manage medical records from various physicians and healthcare systems to enable continuity of care
• Screen members and escalate to nursing and social work team members based on individual member needs
• Assist nursing and social work teams with member follow-up, providing tools and resources as directed
• Monitor stable member populations under the guidance of nursing and social work team members
• Address open care gaps through collaborative relationships with members, ensuring adequate documentation in the medical record
• Coordinate with local community resources to support members' physical and psychosocial needs
• Participate in special initiatives and projects as directed by market leaders

• 3+ years of experience in a medical office or healthcare setting
• Certified Medical Assistant or eligible within 90 days of hire
• Proficiency with technology including Microsoft Office suite
• Experience using electronic health records, including data capture and reporting
• Strong organizational skills with ability to manage multiple tasks simultaneously
• Demonstrated ability to engage diverse populations with cultural sensitivity
• Excellent problem‑solving skills and ability to identify issues requiring escalation
• Strong communication skills and ability to build trust with members and team members

• Experience in value-based care or population health management
• Familiarity with care coordination workflows in a primary care setting
• Knowledge of community resources and social determinants of health

• Opportunity to directly impact member outcomes and care coordination across our payvider model
• Collaborative and dynamic work environment
• An organization made of people who are passionate about changing the healthcare landscape
• Competitive salary and benefits package
• Professional development and growth opportunities
• A transparent and unique culture