Clinical Care Coordinator (RN or LPN, Bilingual Preferred)

FLSA Status

Non-Exempt

Schedule

Flexible part-time schedule (16-20 hours weekly). The nurse may work any combination of consecutive hours between 8:00 a.m. and 5:00 p.m., Monday through Thursday. The specific schedule will be developed collaboratively based on clinic needs and employee availability. Additional Friday hours may be available through community outreach programs.

Potential for expanded hours and full-time employment as clinic services and staffing needs evolve.

Pay

$28-$38 per hour, based on licensure, experience, bilingual proficiency, and community health experience.

Position Summary

The Clinical Care Coordinator supports patient health and continuity of care through chronic disease management, patient education, care coordination, preventive health outreach, and provider-directed follow-up services.

Working within a team-based primary care model, the Clinical Care Coordinator serves as a key resource for patients between provider visits and collaborates closely with providers, the Practice Transition Coordinator, Community Health Worker, and administrative staff to improve health outcomes for uninsured and underserved individuals.

This position focuses on building patient relationships, promoting self-management of chronic conditions, addressing barriers to care, and ensuring patients remain connected to needed medical services and community resources.

Essential Duties and Responsibilities

Patient Follow-Up and Care Coordination

• Conduct follow-up calls with patients regarding treatment plans, medications, test results, and provider recommendations.

• Monitor patient progress and identify barriers to achieving treatment goals.

• Coordinate referrals, specialty appointments, diagnostic testing, and follow-up services.

• Assist patients in navigating healthcare and community resources.

• Collaborate with the Practice Transition Coordinator and Community Health Worker to address social and medical needs.

Chronic Disease Management

• Conduct nurse visits and follow-up encounters within scope of licensure and clinic protocols.

• Support patients with diabetes, hypertension, asthma, and other chronic health conditions.

• Review home blood pressure readings, blood glucose logs, and other patient-reported outcomes.

• Reinforce provider-directed care plans and self-management strategies.

• Identify patient concerns requiring provider review or intervention.

Patient Education

• Provide individualized education regarding chronic conditions, medications, preventive care, and healthy lifestyle choices.

• Reinforce provider instructions and treatment plans.

• Promote medication adherence and self-management skills.

• Communicate effectively with patients across varying health literacy levels.

Preventive Care and Population Health

• Conduct outreach regarding preventive screenings, vaccinations, annual wellness visits, and chronic disease follow-up.

• Support quality improvement and population health initiatives.

• Assist with identifying care gaps and engaging patients in recommended services.

• Participate in community outreach and health education activities as needed.

Clinical Support

• Administer immunizations, injections, and treatments within scope of licensure and clinic policy.

• Document patient interactions and services in the electronic health record.

• Escalate clinical concerns to providers according to clinic protocols.

• Assist with implementation of clinical workflows and patient care initiatives.

Telehealth and Communication

• Conduct follow-up telephone or telehealth encounters within scope of practice.

• Document patient concerns and communicate relevant information to providers.

• Facilitate timely provider follow-up when clinical assessment or treatment decisions are needed.

Required Competencies

Clinical Competencies

• Knowledge of chronic disease management

• Preventive care and patient education skills

• Medication management knowledge

• Ability to recognize changes in patient condition and communicate concerns appropriately

• Understanding of team-based primary care

Communication Competencies

• Excellent verbal and written communication

• Strong patient education skills

• Ability to communicate with diverse populations

• Cultural sensitivity and humility

Professional Competencies

• Strong organizational skills

• Accountability and reliability

• Problem-solving abilities

• Team collaboration

• Commitment to patient-centered care

• HIPAA compliance and confidentiality

Minimum Qualifications

Required

• Current North Carolina RN or LPN license in good standing.

• Minimum one year of experience in primary care, ambulatory care, community health, family practice, care management, or related setting.

• Experience with electronic health records.

• Strong patient education and communication skills.

• Ability to work independently while collaborating effectively with clinical and administrative staff.

Preferred

• Bilingual English-Spanish skills strongly preferred.

• Community health or free clinic experience.

• Experience serving uninsured or underserved populations.

• Chronic disease management experience.

• Care coordination or case management experience.

• Telehealth experience.

Why Join Community Free Clinic?

• Flexible daytime schedule with no evenings or weekends.

• Mission-driven work serving uninsured and underserved community members.

• Opportunity to build meaningful long-term relationships with patients.

• Collaborative, team-oriented environment.

• Potential for expanded responsibilities and full-time employment as the clinic grows.