Job Description

The Maryland Primary Care Program (MDPCP) Care Coordinator will work closely with Primary Care providers in the state of Maryland to identify screen track monitor and coordinate the care of patients with multiple chronic conditions to develop and deliver Comprehensive Primary Care to patients. Our Care Coordinators seek to develop implement and deliver extensive care coordination within our medical group and affiliated partners in a patient centered manner. They interact and collaborate with interdisciplinary care teams population health teams networked facility partners physicians and others involved in meeting the patients needs.

• Collaborate with assigned local teams to meet Maryland Primary Care Program performance metrics
• Own the execution and performance toward defined performance metrics
• Collaborate effectively with integrated care team to support care coordination for patients
• Review patient noncompliance reports and conduct telephonic and/or in person outreach to ensure timely disease specific and wellness visits
• Independently conduct Annual Wellness Visits as needed
• Provide Transitional Care Management including but not limited to post inpatient and/or emergency department discharge follow up
• Provide education and assistance in accessing the necessary care outside of the Primary Care Office
• Collaborate with providers to review highrisk patients develop a plan of care and administer Care Plan to patients
• As needed meet patients in the office or community for facetoface visits
• Provide education and assistance with patient selfmanagement goals
• Identify and coordinate referrals to community resources home care and disease management programs within Privia Preferred Network
• Operate independently within defined practice(s) and patient population to achieve agreed upon goals
• Attendance and participation in regular care team meetings to discuss patient care
• Perform other duties as assigned

Qualifications :

• Clear understanding of MDPCP program mission vision and goal
• Strong computer and EHR skills and expertise
• Preferred experience with Medicare aged patients in a valuebased program
• Preferred experience educating and engaging patients
• Experience working in an outpatient medical office
• Ability to travel to and from care centers to meet with patients and providers
• Must comply with all HIPAA rules and regulations

The salary range for this role is $51000.00 $63000.00 in base pay and exclusive of any bonuses or benefits (medical dental vision life and pet insurance 401K paid time off and other wellness programs). This role is also eligible for an annual bonus targeted at 10% and restricted stock units. The base pay offered will be determined based on relevant factors such as experience education and geographic location.

Additional Information :

Technical Requirements (for remote workers):

In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like  This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Technical Requirements (for remote workers only not applicable for onsite/in office work):

In order to successfully work remotely supporting our patients and providers we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age color national origin physical or mental (dis)ability race religion gender sex gender identity and/or expression marital status veteran status or any other characteristic protected by federal state or local law.  

Remote Work :

No

Employment Type :

Fulltime

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