Communicate and provide resources to patients and caregivers about patient\xe2\x80\x99s conditions and treatment requirements
Recognize and appropriately manage challenging behaviors of patients and caregivers
Liaise and follow through with patients and all health and social care providers to keep everyone informed and updated
Organize patient information for efficient data transfer to relevant internal staff and external providers
Receive and collate information from new, existing, and transfer patients
Liaise with other providers to ensure patients at risk are monitored adequately
Conduct checks on data input to ensure quality and consistency
Generate reports for population health management
Coordinate among multidisciplinary teams in the provider\xe2\x80\x99s setting
Liaise with clinical and non-clinical staff for effective patient management
Organize and manage minutes of internal meetings as needed
Follow-up and tracking of preventive screening results to ensure the timeliness and completeness of follow-up as specifications and care-pathway
Internal Interactions:
Clinical lead
Physicians within the facility
Administrative within the facility
Other clinically trained personnel such as pharmacists, technicians, physiotherapists, nurses, etc.
External Interactions
Other healthcare providers
Service providers such as rehabilitation centers, home care facilities, dialysis centers, outpatient pharmacies, etc. - Social care services are provided by psychologists, behavioral analysts, social workers, counselors, etc.