Current jobs related to Care Coordination Specialist - Visalia - KAWEAH HEALTH
-
Patient Care Coordination Lead
1 week ago
Visalia, California, United States Family HealthCare Network Full timeJob Overview: The Patient Care Coordination Lead is responsible for overseeing departmental personnel, demonstrating effective leadership by recruiting and developing talent. This role includes managing the performance of assigned team members, which encompasses recognition, performance assessments, formal coaching, and making informed decisions regarding...
-
Health Care Specialist
3 months ago
Visalia, United States U.S. Army Full timeThe Health Care specialist is primarily responsible for providing emergency medical treatment at the point of wounding on the battlefield, limited primary care, and health protection and evacuation from a point of injury or illness. Job Duties:Administer emergency medical treatment to battlefield casualties.Assist with outpatient and inpatient care and...
-
Patient Care Coordination Associate
1 week ago
Visalia, California, United States KAWEAH HEALTH Full timeKaweah Health is a community-focused healthcare organization dedicated to delivering a wide range of health services to the surrounding region. With a workforce exceeding 5,000, Kaweah Health is committed to providing advanced medical care and high-quality preventive services through its various healthcare facilities. Our extensive healthcare network...
-
Critical Care Program Coordinator
1 week ago
Visalia, California, United States 10046 Sound Inpatient Phys Inc (SIP) Full timeJob OverviewAbout Sound Inpatient Physicians:Sound Inpatient Physicians is a national, multi-specialty medical group dedicated to delivering exceptional healthcare services across numerous facilities. Our organization is comprised of a diverse team of healthcare professionals, including physicians, advanced practice providers, and nursing staff, all...
-
Critical Care Coordinator
1 month ago
Visalia, United States 10046 Sound Inpatient Phys Inc (SIP) Full timeJob DescriptionJob DescriptionAbout Sound:Headquartered in Tacoma, WA, Sound Physicians is a physician-founded and led, national, multi-specialty medical group made up of more than 1,000 business colleagues and 4,000 physicians, APPs, CRNAs, and nurses practicing in 400-plus hospitals across 45 states. Founded in 2001, and with specialties in emergency and...
-
Program Coordination Specialist
3 days ago
Visalia, California, United States Community Services and Employment Training, Inc. Full timeJob OverviewThe Program Specialist plays a vital role in delivering administrative and clerical support to ensure the smooth operation of front desk activities. This position is essential for maintaining a professional and organized environment for agency partners, program participants, and center staff.Key Responsibilities:Manage the telephone communication...
-
Accounting Specialist
1 week ago
Visalia, California, United States Perfect Care Landscape & Maintenance Full timeJob OverviewWe are seeking a dedicated Accounting Specialist/Administrative Support professional to manage financial documentation and assist with various office responsibilities. This role involves the meticulous preparation and review of financial records, payroll processing, and additional administrative tasks.Key Responsibilities:Accurately input and...
-
Personal Care Attendant
2 months ago
Visalia, United States Prestige Care Visalia Full timePersonal Care Attendant (PCA) Caregiver - On-Call Prestige Care - Visalia Visalia, CA Pay Rate: Hourly Pay Rate Maximum: 23.50 Pay Rate Minimum: 16 Wage range $16.00-$23.50 + shift differentials. DOE and seniority with Prestige. Job Summary: Provides direct resident care,completes assignments as a universal...
-
Program Coordinator
3 days ago
Visalia, California, United States Community Services and Employment Training, Inc. Full timeJob OverviewThe Program Specialist plays a crucial role in delivering administrative and clerical support to ensure smooth operations at the front desk. This position is vital for maintaining a professional and organized environment for both agency partners and program participants.Key Responsibilities:Manage telephone communications, including answering...
-
Program Coordinator
3 days ago
Visalia, California, United States Community Services and Employment Training, Inc. Full timeJob OverviewThe Program Specialist at Community Services and Employment Training, Inc. plays a crucial role in ensuring smooth front desk operations. This position is designed to provide comprehensive administrative and clerical support to facilitate effective communication and service delivery to clients and staff.Key Responsibilities:Manage the telephone...
-
Travel Nurse RN
4 days ago
Visalia, California, United States HealthEcareers - Client Full timeJob SummaryHealthEcareers - Client is seeking a highly skilled Travel Nurse RN to join their team in a critical care setting. As an ICU Specialist, you will be responsible for providing exceptional patient care and collaborating with the healthcare team to ensure the best possible outcomes.Key ResponsibilitiesPerform ongoing assessments, tests, and patient...
-
Dental Care Specialist
13 hours ago
Visalia, California, United States Choice Healthcare Services Full timeJob Summary:Choice Healthcare Services is seeking a skilled and compassionate Dentist to join our team on a part-time basis. As a Dental Care Specialist, you will have the opportunity to provide high-quality dental care to children in the Visalia School District.Responsibilities:Provide quality dental care to all patients, including visual exams and dental...
-
Environmental Compliance Specialist
4 days ago
Visalia, California, United States Pinnacle Recruitment Services Full timeJob DescriptionEnvironmental Compliance SpecialistPosition Overview:The Environmental Compliance Specialist is tasked with ensuring that the food production organization adheres to all relevant environmental regulations and standards. This position requires the monitoring, evaluation, and execution of environmental policies and practices aimed at minimizing...
-
Regulatory Compliance Coordinator Environmental
3 weeks ago
Visalia, United States Pinnacle Recruitment Services Full time $70 - $85Job DescriptionJob DescriptionRegulatory Compliance Coordinator- EnvironmentalJob Summary:The Regulatory Compliance Coordinator- Environmental is responsible for ensuring that the food manufacturing company complies with all applicable environmental regulations and standards. This role involves monitoring, analyzing, and implementing environmental policies...
-
Visalia, United States Pinnacle Recruitment Services Full time $70,000 - $85,000Job DescriptionJob DescriptionRegulatory Compliance Coordinator- EnvironmentalJob Summary:The Regulatory Compliance Coordinator- Environmental is responsible for ensuring that the food manufacturing company complies with all applicable environmental regulations and standards. This role involves monitoring, analyzing, and implementing environmental policies...
-
Senior Employee Relations Specialist
4 days ago
Visalia, California, United States Phoenix Resource Group Full timeJob Title: Senior Employee Relations SpecialistAt Phoenix Resource Group, we are seeking a highly skilled Senior Employee Relations Specialist to join our Human Resources Solutions team.Job SummaryThis is a key role that requires a strong understanding of employee relations and the ability to provide expert guidance to our business units.Deliver employee...
-
Safety Compliance Specialist
1 week ago
Visalia, California, United States Jobot Full timeJoin Our Team as a Safety Compliance SpecialistCompensation and Benefits:We offer a competitive salary range of $65,000 - $75,000 annually, alongside a comprehensive benefits package that includes full medical coverage, 401k matching, potential bonuses, and a company vehicle with expense reimbursements.About Us:We are a privately owned organization dedicated...
-
Culinary Support Specialist
1 week ago
Visalia, California, United States Quail Park Full timeWelcome to Quail Park Memory Care Residences of Visalia Our establishment, characterized by its craftsman-style architecture, offers a nurturing atmosphere where residents can engage and flourish. Become an integral part of our mission to enhance the quality of life for our residents.Position: Culinary Support SpecialistAre you dedicated to serving older...
-
Elderly Care Specialist
1 week ago
Visalia, California, United States Quail Park Full timePosition OverviewAt Quail Park, we provide a vibrant environment where our residents can thrive socially and physically in beautifully designed living spaces.Responsibilities of the CaregiverDeliver personal care and support while monitoring the health and wellness of residents.Facilitate social interactions and activities for residents.Monitor and report...
-
Recruitment Specialist
1 week ago
Visalia, California, United States California Dairies Full timePosition OverviewThe Talent Acquisition Specialist plays a crucial role in the comprehensive recruitment process, which encompasses sourcing candidates, conducting interviews, and facilitating hiring decisions.Key Responsibilities- Manage the full cycle of recruitment for both salaried and hourly positions.- Assist in the onboarding process for qualified...
![KAWEAH HEALTH](https://media.trabajo.org/img/noimg.jpg)
Care Coordination Specialist
1 month ago
Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care.
It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do - in the health of our patients, our loved ones, and our community.
Benefits Eligible
Full-Time Benefit Eligible
Work Shift
Day (United States of America)
Department
8790 Case Management
The Care Coordination Specialist works in collaboration with RN Case Management (CM) staff to gather clinical data to monitor quality and effectiveness of patient care. Acts as a liaison between RN CM and insurance companies by transmitting clinical data for review. Assists with planning and execution of safe discharge plan in a timely manner while working in collaboration with the multi-disciplinary team.
QUALIFICATIONS
Education
Required: Two years of college or equivalent training/experience in health-related field
Experience
Required: Utilization review and/or coding experience
Knowledge/Skills/Abilities
Must understand basic medical terminology.
Strong organizational and multitasking skills, with the ability to manage multiple patients and tasks simultaneously.
Excellent communication and interpersonal skills, with the ability to interact effectively with patients, families, and healthcare professionals.
Knowledge of discharge medication delivery processes and procedures, including coordination with the outpatient pharmacy and the patient and or family.
Ability to work collaboratively with interdisciplinary team members and healthcare professionals.
Strong computer skills, with proficiency in electronic medical record documentation preferred. Proficient in using Excel for documentation.
JOB RESPONSIBILITIES
Essential
Reviews and records utilization review data for assigned caseload in a manner to ensure all inpatient records are current.
Refers to Case Management team any variances that relate to concurrent review of the medical record. During chart review, is aware of criteria for quality variances. Complies with Kaweah Health Policy by reporting utilization variances to Case Management Committee and/or the P.I. department as indicated.
Reviews medical records for admission and continued stay utilizing InterQual Severity of Illness and Intensity of Services for appropriateness of the admission and continued stay. Must also review all cases transferred in and out of special/intensive care areas using specific criteria. Participants in Sub Committee reviews as designated.
Informs the Case Management Team and attending physician of any questionable or denied cases resulting from the review of the onsite Medi-Cal reviewer, CMRI or private insurance companies. Initiates further action by following guidelines set forth in the Hospital Case Management Plan.
Facilitates and coordinates placement of patients in appropriate long-term care facilities.
Facilitates arrangements for acute transfer to other acute facilities when indicated.
Assists case management team with discharge planning services that can include coordination of equipment, home care, home health, and transportation services.
Participates in Continuum of Care rounds.
Accumulates information on community resources and links patients, families and staff to appropriate services.
Answers the telephone, screens calls and takes messages as appropriate, per hospital protocol.
Addendum (essential for specific dept)
INSURANCE SPECIALIST:
Responsible for all clerical aspects of utilization review including, but not limited to, processing of referrals, input of authorizations into the system, mailing of referrals and attendance at Case Management meetings. Maintains & manages all health plan benefit databases in the system and updates as needed. Transmission of insurance reviews (Initial & Concurrent). Takes telephone requests for authorizations. Completes retro reviews in a timely manner. Documents authorizations in SoftMed and Invision. Completes CCS and other referrals as indicated with appropriate documentation. Communicates payer needs to Case Managers in a timely manner. Generates reports that summarize referrals and authorization activity. Coordinates the denial appeal process in conjunction with management/RN supervision, including but not limited to writing and/or calling appeals to private insurers and Medi-cal. Coordinates the input of registrar data and provides assistance to the RN Admissions Coordinators in placement of patients and physician communication. Cross-trains in various functions as designated by management including but not limited to acute care, surgery, transitional care, registration, mental health, and acute rehab coverage.
HOME HEALTH:
Responsible for all clerical aspects of utilization review including, but not limited to, processing of referrals and input of authorizations in the system. Generates reports that summarize referrals and authorization activity. Tracks documentation of face-to-face encounters and communicates with doctors to obtain signatures when needed. Establishes the availability of funds for the services required. Communicates with patient and appropriate administrative and patient accounting personnel throughout the process. Communicates with unit staff, patient and case management concerning special wound supply needs/equipment of patient to be admitted to home health. Maintains current authorizations for all insurance sources. Maintains monthly statistics through referral log. Assures all intake information is complete and accurate including patient information (phone number and address) physician information (name, address, phone and fax number) and insurance information. Inputs all necessary data into the intake system accurately and timely. Responsible for securing and documentation all insurance authorizations and reauthorizations on assigned cases working closely with agency case managers to assure all visits are authorized. Performs a review on all completed admissions within five business days of receipt checking all areas outlined in the admission review process to assure complete and accurate information. Notifies patient's PCP of home health referral prior to accepting referral to assure PCP is willing to follow and sign for home health services.
DISCHARGE LOUNGE:
Works with the Discharge LVN to identify appropriate patients for the lounge, based on clinical criteria and capacity of the lounge.
Oversees the flow of patients through the discharge lounge (inbound and outbound) through coordination with the Registered Nurses or the Discharge LVN.
Coordinates patient pick up from the medical units, transports patients to and from the discharge lounge, to waiting vehicles, or assists patients to the restrooms as needed.
Responsible for data collection of patient information, arrival time to the lounge, duration of stay, and medication delivery from the outpatient pharmacy.
Assists with the coordination of medication delivery to the discharge lounge, including working with pharmacy and nursing staff to ensure timely and accurate delivery of medications.
Receives patients and orients them to facilities within the lounge such as reading materials, television, refreshments and exit and restroom locations.
Supports the care for patients; ensures safety of patients in the lounge and management of operation issues in the discharge lounge.
Collaborates with interdisciplinary team members to ensure effective communication and coordination of care for patients in the lounge, and follows up on the needs of the patients as instructed by Registered Nurses or Discharge LVN.
Communicates effectively with patients and families to ensure understanding and compliance with lounge policies and procedures, and to arrange pick up times.
Provides feedback to the Throughput Supervisors related to discharge lounge and medication delivery processes.
Additional
Participates in training of all newly hired Care Coordination staff. Assists the employee in the function of the department.
Assists patients with information and review Advance Directives.
Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area.
Performs other duties as assigned.
Pay Range
$20.38 -$30.57
If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong.