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Clinical Care Coordinator

2 months ago

Columbus, Ohio, United States Apree Health Full time
Apree Health Clinical Care Coordinator Job Description

Apree Health is seeking a skilled Clinical Care Coordinator to join our team. As a Clinical Care Coordinator, you will play a vital role in condition management services, with a focus on Complex Case Management.

Responsibilities:
  • Ability to understand the impact of high and rising risk populations on the total cost of care
  • Utilize systems and tools provided to identify individuals in need of gap closure, care coordination, and follow-up activities
  • Address overutilization of ED services and provide level of care steerage and education
  • Assess and participate in care team meetings to ensure appropriate clinical care, support programs, coaching, and case management programs are being utilized
  • Participate in wellness outreach and services to encourage preventive health screenings and health maintenance
  • Provide education related to disease states, treatment options, lifestyle modifications, and health literacy when needed
  • Collaborate with Care Guides to assist patients with benefits education, referrals, billing & claims, eligibility, and digital platform concerns
  • Provide RN Triage per established guidelines
  • Compliance with all confidentiality protocols and applicable laws
  • Document accurately and thoroughly, adhering to all good documentation practices
  • Must be eager to receive and apply routine feedback for continuous improvement as a result of call and case documentation reviews
  • Receive escalations for medically complex needs and questions
  • Other duties as assigned
Qualifications:
  • Minimum 4-5 years of relevant clinical experience
  • BSN or MSN preferred
  • Unencumbered registered nursing license with at least a compact license with intent to complete state licensure in 50 states plus the District of Columbia
  • Experience in a multi-channel healthcare support environment a plus
  • Experience in case management, care management, or clinical coordination a plus
  • Multiple system experience including EMR, Salesforce, and Google suite
  • Willing to provide a list of required information for our credentialing process
  • Knowledge of insurance standards and the payer/provider relationship including referral management, prior authorizations, and medical necessity documentation
  • Familiarity with HEDIS and STAR quality measures and gap closures preferred
Physical Demands:
  • Requires being at a desk for extended periods of time
Compensation:

$85k-$104k/annual salary (national average, premium markets may vary)