Clinical Care Coordinator

4 days ago


San Diego, California, United States NeueHealth Full time

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 Role

This 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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