Clinical Care Coordinator
4 days ago
At NeueHealth, we're dedicated to delivering quality healthcare services that meet the unique needs of our patients. As a Clinical Care Coordinator, you'll play a critical role in ensuring seamless transitions between care settings and advocating for our members' health and social outcomes.
About the RoleThis is an exciting opportunity to join our team as a Utilization Management Nurse, working closely with Medical Directors and other stakeholders to ensure high-quality patient-centered care. Your responsibilities will include:
- Conducting prospective, retrospective, or concurrent medical necessity reviews for assigned panels of members
- Applying clinical criteria, including Medicare, Medicaid/Medi-cal, Interqual, Milliman, and Health Plan-specific guidelines
- Collaborating with the Medical Director to ensure integrity of adverse determination notices
- Ensuring timely discharge planning and effective communication with transition-of-care teams
To succeed in this role, you'll need:
- An Associate's degree in Nursing (or equivalent)
- A minimum of 2 years' experience in medical management clinical functions
- Working knowledge of MCG, InterQual, and NCQA standards
- An active and unrestricted License as a Licensed Vocational Nurse (LVN)
We offer a competitive compensation package, including:
- A reasonable estimate of the hourly range: $26.31-$39.46 per hour
- Health benefits
- Life and disability benefits
- A 401(k) savings plan with match
- Paid Time Off and paid holidays
We're committed to creating a work environment that fosters growth, collaboration, and excellence in patient care. Join us at NeueHealth and take the first step towards an extraordinary career
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