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Care Coordinator PASRR
4 months ago
Job Summary
As a Care Coordinator, you will play a crucial role in contacting hospitals, nursing homes, or community-based settings to gather all relevant information to determine the status of a Level II PASRR referral for individuals admitting Medicaid Skilled Nursing facilities.
Job Responsibilities:
Ensure accurate transmission of Level II referrals from DHCS. Contact NF and GACH facilities to verify individual status, request medical records, and manage PASRR activities to ensure timely processing of referrals.
Maintain thorough documentation of all PASRR activities within the state and in the Atrezzo System, ensuring compliance with DHCS timeframes for Level II referrals.
Assist in preparing reports on Level II data and provide technical and clerical support to the Clinical Director, Evaluators, QA Managers, and Medical Directors.
Request clinical technical assistance to determine the necessity and classification of Negative Level I or Categorical Determinations.
Manage, transfer, and coordinate incoming PASRR-related calls.
The schedule includes weekend shifts and hours from 8:30 AM to 5:30 PM, including some holidays.
Required Qualifications and Experience
Minimum of 1 to 2 years of recent experience in a clinical environment, preferably in field delivery.
Experience in the public sector, such as with Commercial, Medicare, or Medicaid, is preferred.
Strong verbal and listening skills, ensuring courteous and professional customer service, with clear telephone communication abilities.
Knowledge and familiarity with public sector health coverage systems, such as Medicare and Medicaid.
Understanding of the principles, ethics, and precepts of care management service delivery.
Proficiency in computer skills, including care management applications, Internet/Web usage, and Microsoft Office (Word, Excel).
Strong prioritization and organizational skills, enabling effective management of multiple tasks and responsibilities.
Ability to demonstrate purposeful and outcomes-directed critical thinking in daily operational activities.
Capacity to receive verbal and written feedback professionally and implement performance and productivity improvements as needed.
Skill in interpreting real-time and historical information to inform decision-making and optimize care coordination efforts.
Proficiency in PC skills, including electronic mail, intranet, and industry-standard applications.
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