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What You'll Be Doing

The Care Coordinator plays a key role in supporting patients with complex medical needs. Working under the supervision of the CCM Manager, you will work directly with patients, providers, and care teams to ensure coordinated, patient-centered care. This is an on-site, hourly role with a set Monday-Friday, 8:00 a.m.-5:00 p.m. schedule. It emphasizes patient engagement, care planning, and ongoing follow-up to prevent unnecessary hospitalizations and promote better health outcomes - delivered with the responsiveness and polish this building's patients and families expect.

Key Responsibilities

• Performs outbound calls to patients to understand their clinical needs and connect them with appropriate resources. Performs outbound calls to providers to make appointments for patients or follow up on care. Answers inbound calls from patients, providers, and other resources.
• Serves as a warm, responsive point of contact for patients and families, setting clear expectations and closing the loop on every request.
• Follows up with patients to ensure their needs are met and schedules future check-ins.
• Monitors patient hospitalizations and follows up as necessary with care team members and outside resources to confirm Fortis Care gathers all relevant patient information.
• Provides patients and family with education materials and sends communications to specialists for new enrollments/appointments.
• Help identify and prioritize patients for medical services each day, including setting the schedule and prepping any charts to enable efficient and effective provider visits.
• Coordinate care transitions, including timely post-hospital follow-up, medication reconciliation, and education on discharge instructions.
• Partners closely with the on-site Advanced Practice Provider, facility nursing, therapy, and social work teams to keep care and communication seamless.
• Document all care management activities accurately and in a timely manner.

Skills & Abilities

• Exceptional communication skills (verbal, written, and listening) - you are clear, prompt, and easy to reach.
• Strong customer service orientation, with the patience and professionalism to manage high expectations from patients, families, and referring providers.
• Strong clinical knowledge of chronic disease management.
• Ability to engage with patients and families in a supportive, empathetic, and culturally competent manner.
• Strong organizational skills and attention to detail.
• Ability to work independently while collaborating with providers and team members.
• Problem-solving skills with a focus on patient-centered outcomes.

Qualifications

• Licensed Practical Nurse (LPN) or Medical Assistant (MA) required.
• Minimum 1-2 years of experience in care coordination, chronic care management, primary care, ambulatory care, skilled nursing, or hospital settings.
• Knowledge of chronic conditions, evidence-based guidelines, prevention, and patient education.
• Experience with care management documentation and EHR systems preferred.
• Associate's degree or higher in a clinical or health-related field preferred.
• Experience with quality improvement or care coordination a plus.
• Prior experience in a service-forward, concierge, or hospitality-oriented setting a plus.
  

Benefits Package

• Hourly, non-exempt position
• Set Monday-Friday, 8:00 a.m.-5:00 p.m. schedule - no weekends or evenings
• Flexibility to come and go outside of core care coordination meeting times
• Healthcare reimbursement account to cover medical, vision, and dental Insurance
• 401(k) plan after first year of employment
• 10 days paid vacation and 5 paid holidays
• Family-friendly work environment
  

Why Fortis Care

At Fortis Care, we believe every patient deserves attentive, high-quality care delivered where they are. Our physician-led team partners with nursing facilities to provide expert, consistent, and compassionate medical services right at the bedside.

We take a holistic approach to health, combining medical expertise with care coordinators who ensure patients' needs are met across the continuum of care. From reducing avoidable hospitalizations to empowering patients and families with tools for self-management, our mission is to improve outcomes while treating every patient with dignity and respect.

This role supports one of the most highly regarded upscale rehabilitation and transitional care buildings in Northeast Atlanta - an all-private-suite facility where chef-prepared dining, concierge services, and a hotel-caliber guest experience are the standard. Patients and families there expect responsiveness, warmth, and follow-through, and the Care Coordinator is often the voice they hear most.

As part of Fortis Care, you'll join a collaborative, mission-driven team that values independence, ownership, and doing the right thing for patients and partners. We invest in our people, celebrate hard work, and provide opportunities to grow alongside a company that is redefining post-acute care.

Employment Type: FULL_TIME