Clinical Care Coordinator

4 weeks ago


Bronx, New York, United States MONTEFIORE MEDICAL CENTER Full time
Job Summary:

The Clinical Care Coordinator will play a critical role in coordinating medical care services for patients. This includes ensuring efficient utilization of resources, delivering high-quality patient care, and maintaining compliance with relevant regulatory, accrediting, and contractual requirements.

Key Responsibilities:

Assess the appropriateness of patient care services
Prepare and submit clinical appeals for denied claims
Compile and analyze data to support utilization reviews, quality improvement initiatives, and other areas as assigned

Requirements:

BSN or a bachelor's degree in a related field required
Master's preferred
NYS RN License required
PRI assessor number required prior to end of 3-month probationary period
3-5 years recent acute care clinical experience preferred
Experience in utilization management preferred
Experience in a managed care organization preferred
Certification in Utilization Review or Case Management preferred

What We Offer:

Competitive salary and benefits package
Opportunities for professional growth and development
Collaborative and dynamic work environment

About Us:

Montefiore Medical Center is a premier academic medical center that transforms health and enriches lives. We are committed to delivering high-quality patient care, advancing medical knowledge, and promoting health and wellness in the communities we serve.

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