Clinical Care Coordinator RN

2 days ago


Dallas, Texas, United States Steward Health Care Full time

The Clinical Care Coordinator RN assumes primary responsibility for documenting medical necessity for inpatient status or observation placement at Steward Health Care. This role communicates with physicians and clinicians to ensure timely and cost-effective care coordination.

KEY RESPONSIBILITIES:

  • Utilize a systematic methodology to assess, plan, implement, evaluate, and provide patient care coordination from pre-hospital through post-hospital care.
  • Assist in developing physician profiles to identify over/under utilization patterns.
  • Support Steward Health Care's goals and objectives while working within regulatory compliance guidelines.
  • Collaborate with healthcare disciplines to ensure appropriate and timely services.
  • Assess the medical appropriateness, quality, and cost-effectiveness of proposed hospital, medical, and surgical services.
  • Collaborate with the multidisciplinary team to assist patients with benefits management.
  • Communicate with payers to obtain authorization.
  • Identify and plan strategies to optimize inpatient length of stay and resource utilization.

REQUIRED KNOWLEDGE & SKILLS:

  • Ability to work competently with computer-based charting and clinical software programs.
  • Adaptability to change and good organizational skills required, with the ability to read and communicate effectively in English.
  • Ability to do presentations and work with Microsoft Office Products, including Excel, Word, and other software.
  • Leadership skills required for mentoring, coaching, counseling, time management, problem solving, and strategic planning.
  • Ability to demonstrate initiative and a proactive approach to problem resolution.
  • Ability to effectively interact with insurance companies and community healthcare resources.
  • Ability to work in a stressful, fast-paced environment.
  • Understanding of CMI, patient status, InterQual Criteria, Milliman Criteria, and Transfer DRGs.

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

  • Education: Bachelor's degree required; Master's degree preferred.
  • Experience: Three to five years of acute medical/surgical experience plus three to five years of Case Management experience.
  • Certification/Licensure: RN license required; Certification in Case Management (CCM) strongly preferred.
  • Software/Hardware: Strong knowledge in Microsoft Office applications.
  • Other: Understanding of the healthcare delivery setting.


  • Dallas, Texas, United States Pinnacle Clinical Research Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Clinical Research Coordinator I to join our team at Pinnacle Clinical Research. As a key member of our research team, you will be responsible for managing the day-to-day operations of assigned clinical trials, ensuring that all pre-established work scope, study protocol, and regulatory...


  • Dallas, Texas, United States Pinnacle Clinical Research Full time

    About the RolePinnacle Clinical Research is seeking a highly skilled and detail-oriented Clinical Research Coordinator I to join our team. As a key member of our research team, you will be responsible for managing the day-to-day operations of assigned clinical trials, ensuring compliance with study protocols, and collaborating with internal and external...


  • Dallas, Texas, United States UT Southwestern Medical Center Full time

    Job SummaryUT Southwestern Medical Center is seeking an experienced Ambulatory Registered Nurse (RN) Coordinator to join our Spine Clinic team. As a RN Coordinator, you will play a vital role in providing excellent patient education, triaging, and supporting the clinic. This position will function as a team lead for the clinic, ensuring patient care...


  • Dallas, Texas, United States Health Care Service Corporation Full time

    At Health Care Service Corporation, we empower our employees with curated development plans that foster growth and promote rewarding, fulfilling careers.This position is responsible for ensuring accurate and timely clinical review of behavioral health cases for medical necessity, including assisting members on the telephone, reviewing medical records, and...


  • Dallas, Texas, United States Health Care Service Corporation Full time

    Job SummaryC1 Innovation Lab (Dallas) is a cutting-edge facility that puts our members first, imagining, exploring, nurturing, and activating on their behalf.This role is responsible for performing a variety of functions and is a single source of contact for members, healthcare personnel, and other entities involved in managing care.Identifies alternate...


  • Dallas, Texas, United States United Surgical Partners Full time

    Job Title: Case ManagerBaylor Scott & White Medical Center – Uptown is a joint venture surgical hospital between Baylor Scott & White Health (BSWH), United Surgical Partners International (USPI), and local physicians.The hospital provides a wide range of medical and surgical services to the greater North Texas area, including orthopedics, joint...

  • Care Coordinator RN

    3 weeks ago


    Dallas, Texas, United States trustaff Full time

    About this roleAs a Care Coordinator RN with Trustaff, you'll be responsible for developing, implementing, and evaluating individual patient care plans. You'll work closely with patients and their families to ensure they receive the best possible care. This role requires strong communication and organizational skills, as well as the ability to work...

  • RN Clinical Liaison

    4 weeks ago


    Dallas, Texas, United States Gentiva Full time

    About GentivaGentiva is a leading provider of hospice, palliative, and personal care services, with a presence in 36 states and over 430 locations. Our team of compassionate clinicians is dedicated to delivering high-quality care to patients and their families, helping them navigate the complexities of serious illness or terminal diagnosis.Job SummaryWe are...


  • Dallas, Texas, United States Nursing Solutions Full time

    About the RoleWe are seeking a highly skilled and compassionate Registered Nurse (RN) to join our team as a Clinical Care Manager. As a key member of our pediatric home health team, you will be responsible for providing high-quality patient care and ensuring the delivery of compliant care services.Key ResponsibilitiesAssure direct care staff functions...

  • RN Clinical Liaison

    4 weeks ago


    Dallas, Texas, United States Gentiva Health Services Full time

    About the RoleWe are seeking a highly skilled RN Clinical Liaison to join our team at Gentiva Health Services. As a RN Clinical Liaison, you will play a critical role in educating healthcare professionals about our hospice services and providing end-of-life solutions that are committed to clinical excellence, compassion, and dignity.Key...


  • Dallas, Texas, United States VA North Texas health care Full time

    Job Title: Women's Health Care CoordinatorJob Summary:The Women's Health Care Coordinator is a registered nurse responsible for coordinating patient-centered care and services for women Veterans. This role requires a strong understanding of women's health care and the ability to work collaboratively with patients, VA staff, and non-VA care providers to...


  • Dallas, Texas, United States Methodist Health System Full time

    Job Summary:The Research Coordinator 2 will play a vital role in the coordination of all phases of the research process, ensuring compliance with FDA, IRB, and other regulatory agencies. This position requires a strong understanding of clinical trials, data management, and patient care.Key Responsibilities:Coordinate data collection, management, and...


  • Dallas, Texas, United States VA North Texas health care Full time

    Job SummaryWe are seeking a highly skilled and compassionate Registered Nurse to join our team as a Women's Health Care Coordinator at the VA North Texas Health Care System. As a key member of our healthcare team, you will play a vital role in providing exceptional patient care and services to our female veterans.Key ResponsibilitiesWork in partnership with...

  • RN Care Coordinator

    3 weeks ago


    Dallas, Texas, United States UT Southwestern Medical Center Full time

    Why UT Southwestern?At UT Southwestern Medical Center, we're committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report,...


  • Dallas, Texas, United States University of Texas Southwestern Medical Center Full time

    Ambulatory Registered Nurse Coordinator plays a vital role in the Spine Clinic at UT Southwestern Medical Center. This position is responsible for providing excellent patient education, triaging, and supporting the clinic. As a team lead, the RN Coordinator will ensure efficient and effective patient care coordination of clinical procedures.Key...


  • Dallas, Texas, United States Custom Care Home Health & Hospice Full time

    Job SummaryThe Nurse Care Coordinator plans, organizes, and directs hospice care, with a focus on community health education and experience.The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individuals and families within their homes and communities.Patient CareCompletes an initial,...

  • Care Coordinator

    4 weeks ago


    Dallas, Texas, United States Custom Care Home Health & Hospice Full time

    Job SummaryThe Intake Coordinator is a critical role within Custom Care Home Health & Hospice, responsible for managing the patient intake process from start to finish. This includes communicating with patients and families, data entry, and establishing relationships with referral sources. The ideal candidate will have experience in healthcare, preferably in...

  • Clinical Liaison RN

    4 weeks ago


    Dallas, Texas, United States New Century Hospice Full time

    About New Century HospiceNew Century Hospice, part of the Gentiva family of hospice, home health, palliative, and community care providers, is dedicated to delivering clinical excellence with compassion and dignity. Our company culture centers around humility, servant leadership, empathy, and innovation while we serve as a leader in the home care...


  • Dallas, Texas, United States Option Care Health Full time

    Job Title: Clinical Care Transition SpecialistAt Option Care Health, we are committed to providing extraordinary care that changes lives. As a Clinical Care Transition Specialist, you will play a critical role in ensuring seamless transitions for patients from hospital to home or alternative site care.Key Responsibilities:Proactively establish and maintain...


  • Dallas, Texas, United States Medical City Healthcare Full time

    Medical City Healthcare is seeking a skilled Registered Nurse to fill the role of Clinical Nurse Coordinator in our Telemetry department. As a key member of our team, you will be responsible for delivering high-quality patient care and coordinating all functions in the unit. In partnership with our management team, you will monitor and evaluate nursing care...