Clinical Care Coordinator

21 hours ago

Norwalk, Connecticut, United States Norwalk Hospital Association Full time
Job Summary

The Clinical Care Coordinator - ED acts as a liaison between emergency services, surgical services, nursing, finance, physicians, utilization review, and Health Information Management to ensure the appropriate level of care is assigned, progression of care is efficient, and discharge/transition plans are executed as needed.

Responsibilities
  • Manages the Utilization Review elements of the ED encounter for all patients for whom hospitalization is being considered to assure the correct level of care and the optimal initial care plan.
  • Makes recommendations for Bed Request orders through thorough review of available clinical information and use of evidence-based screening criteria.
  • Refers cases appropriately to Physician Advisor review.
  • Collaborates with SW Care Coordinators to assure optimal plans of care for discharge.
  • Analyzes clinical, financial, and social situations, while identifying problems and establishing alternative courses of action.
  • Performs rounding with members of the ED team to assure appropriate case identification and planning discussions.
  • Advises/educates patients and families on guidelines pertaining to hospitalization and of options for discharge planning.
  • Issues all required regulatory notices (Condition 44, HINN, ABN) as appropriate.
  • Offers suggestions and new ideas for improving performance and operations.
  • Guides, directs, and educates the health care team to assure optimal outcomes.
  • Monitors ED throughput and assists in facilitation of testing and procedures.
  • Participates in all community teams for management of complex and high recidivist patients.
Requirements
  • Registered Nurse license State of CT with minimum of one year as an acute Care Coordinator.
  • Associates Degree in Nursing.
  • Knowledge and expertise with use of electronic medical record and experience with both Interqual and Milliman screening criteria.
  • Excellent collaborator and team member who is able to work closely with physicians and all members of the health care team to procure the right level of care, correct order for hospitalization, optimal plan of care, and facilitation of services to enhance ED throughput.
  • Knowledge and expertise in CMS and insurance industry standards as well as guidelines pertaining to appropriate coverage notifications.
  • Ability to be flexible, resourceful, and creative in problem-solving.

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