JOB SUMMARY

The PFA Clinical Care Specialist provides support to the field operations team to assess the
medical needs and clinical requirements for medical fragile patients eligible for State HIPP
programs. The Clinical Care Specialist will demonstrate a commitment to excellence by working
cohesively with their PFA Team, Hospital partners and other providers associated with the
patients medical needs. The Clinical Care Specialist will adhere to the PFA mission, vision, and
values as well as our business objectives, goals and deliverables. The Clinical Care Specialist will
initially report to the COO and will actively work across all Regions and Hospitals at PFA working
30 hours a week.

ROLE AND RESPONSIBILITIES
▪ Assessing the medical needs of the patient to understand their full clinical picture
▪ Review health insurance benefit plans to determine if coverage options meet the needs
of the patient.
▪ Coordinate patient care options with Hospital partner and providers post discharge
including but not limited to pediatric hospitals, home health, pharmacy, durable medical
treatment.
▪ Facilitating aspects of the treatment plan, such as care coordination and discussions
with the patient and family of the patient.
▪ Recording all case information including interactions with internal and external teams.
▪ Building strong relationships with the medical team throughout the case management
process.
▪ Communicating with other healthcare providers, specialists, and community services to
ensure coordinated care and seamless transitions.
▪ Responding to clinically complex situations that may arise with patients within 1-2
business days.
▪ Representing the patient's needs and advocating for access to necessary services and
resources.
▪ Attend as needed meetings with healthcare team members to discuss patient medical
needs and obstacles in receiving care.
▪ Consistently demonstrate the ability to successfully operate in problem-solving mode
whenever challenges or concerns arise. Collaborate and communicate for the best
solutions.
▪ Responsible for continued improvement in field operations by training, auditing and
providing specific feedback.
▪ Perform other duties as assigned by leadership.

JOB REQUIREMENTS
▪ A bachelor’s degree in nursing or relevant healthcare field.
▪ A minimum of 3 years working in a clinical setting or similar healthcare role.
▪ Maintenance of existing license such as (RN, ACM,CCM, CNA)
▪ Able to Communicate, be Accountable and work in a Team environment
▪ Ability to work with patients and their families facing disabilities, medical complexities
and multiple provider service needs.
▪ Must be organized and detail oriented with good writing and listening skills

PFA offers medical, dental and vision benefits as well as a 401k program. This is a 30 hour a week position paid hourly.

For more details on this great opportunity, contact careers@insidepfa.com