Clinical Care Coordinator

7 days ago

Nashville, Tennessee, United States HC&N Healthcare Solutions Full time
Overview

HC&N Healthcare Solutions is a leading provider of healthcare solutions, committed to delivering high-quality care to our patients and facilities.

Job Summary

We are seeking an experienced Clinical Care Coordinator (RN) to join our team. As a key member of our interdisciplinary team, you will play a critical role in ensuring the seamless coordination of patient care, from admission to discharge.

Responsibilities

Your primary responsibilities as a Clinical Care Coordinator (RN) will include:

  • Accurate Completion of Resident Assessments: Ensure timely and accurate completion of the Minimum Data Set (MDS), Care Area Assessments (CAAs), and Care Plans, in accordance with federal and state regulations.
  • Case Management: Act as an in-house case manager, demonstrating detailed knowledge of residents' health status, critical thinking skills to develop an appropriate care pathway, and timely communication of needed information to the resident, family, other healthcare professionals, and third-party payers.
  • Regulatory Compliance: Proactively communicate with Administrator and Director of Nursing to identify regulatory risk, effectiveness of Facility/Community Systems that allow capture of resources provided on the MDS, clinical trends that impact resident care, and any additional information that affects clinical and operational outcomes.
  • Care Pathway Development: Utilize critical thinking skills and collaborate with therapy staff to select the correct reason for assessment and Assessment Reference Date (ARD). Capture the RUG score, which reflects the care and services provided.
  • Payer Knowledge: Demonstrate an understanding of MDS requirements related to varied payers, including Medicare, Managed Care, and Medicaid.
  • Electronic Submission: Ensure timely electronic submission of all Minimum Data Sets to the state database. Review state validation reports and ensure that appropriate follow-up action is taken.
  • Care Management Process: Facilitate the Care Management Process, engaging the resident, IDT, and family in timely identification and resolution of barriers to discharge, resulting in optimal resident outcomes and safe transition to the next care setting.
  • IDT Education: Directly educate or provide company resources to IDT members to ensure they are knowledgeable of the RAI process. Provide an overview of the MDS Coordinator and Assessor role to new employees involved in the RAI process.
  • QI/QM Analysis: Analyze QI/QM data in conjunction with the Director of Nursing Services to identify trends on a monthly basis.
  • Utilization Review and Triple Check: Responsible for timely and accurate completion of Utilization Review and Triple Check.
Qualifications

To be successful in this role, you will need:

  • An active TN nurse license.
  • A minimum of two years of clinical experience in a healthcare setting.
  • A minimum of one year of experience in a long-term care setting.
  • Prior experience as an MDS coordinator is accepted.
  • Prior experience with PAE's and PASARR's is preferred.
Compensation and Benefits

We offer a competitive salary of $85,000 per annum, plus a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.

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