Agency for Integrated Care (AIC) funded programme initiative, with focus on integrated physical and mental health support across community networks.
Coordinate comprehensive care for patients with complex needs, serving as the primary liaison between community partners and hospital systems to ensure seamless care transitions and continuity.
Perform miscellaneous job-related duties as assigned.
Key Responsibilities
Care Coordination: Manage patient care plans across hospital and community settings, including discharge planning, appointment monitoring, and care transitions
Community Partnership: Collaborate with community partners for patient follow-up, home visits, and resource linkage
Patient Education: Provide psychoeducation on medication compliance and empower patients in self-care management
Administrative Support: Manage referrals, schedule meetings, maintain programme databases and performance indicators
Data Management: Collect and analyse programme data, participate in research activities and conference presentations
Requirements
Bachelor's degree or diploma in healthcare administration, social work, psychology, or nursing
Minimum 2 years' experience (degree holders) or 10 years' experience (diploma holders) in care coordination or case management
Proven experience in care coordination, case management, or related roles within the medical field.
Strong understanding of healthcare systems and community resources
Excellent communication and interpersonal skills to communicate with diverse stakeholders
Ability to assess and stratify complex care needs based on risk and severity.
Strong organisational skills with attention to detail and the ability to manage multiple tasks simultaneously
#J-18808-Ljbffr