Provide care coordination/case management and linkages with services such as, but not limited to: transportation including to health care or dental appointments, prescription assistance, eligibility assistance with enrolment in entitlement/mainstream benefits, translation and other identified needs to improve access to and utilisation of care.
Assist patients with completing required paperwork, explain clinic policies and processes to help patients understand and navigate available services.
Assist uninsured patients with identifying and determining a health care payor source (e.g. insurance, Medicaid, Medicare, VA or other public benefits) as eligible and/or access to community-based resources (e.g. medication assistance programs).
Assist with service delivery to patients and their families utilising trauma-informed and evidence-based approaches.
Assist with health education/disease prevention by linking patients to community resources and/or providing information where gaps exist.
Maintain records and reports using integrated health records which can be audited for accountability.
Responsible to maintain, and possibly establish if not present, an outside network of applicable community resources, contacts, and maintain relationships as seen fit for CM.