Clinical Care Coordinator
2 weeks ago
Serves as a liaison between the patient and healthcare team to ensure a continuum of quality patient care throughout hospitalization.
Key Responsibilities:
- Facilitates patient management throughout hospitalization, ensuring timely and effective care.
- Performs concurrent utilization management using evidence-based medical necessity criteria to optimize patient outcomes.
- Submits data to management regarding case management and quality initiatives to drive improvement.
- Serves as an in-patient liaison, planning, assessing, implementing, and evaluating patient care in collaboration with the healthcare team.
- Conducts chart review for appropriateness of admission and continued length of stay, facilitating throughput and efficient care.
- Interacts with third-party payers to obtain approval of hospital days, pre-certification, and post-discharge eligibility in relation to clinical course.
- Ensures compliance with current state, federal, and third-party payer regulations.
- Documents the case management process in the medical record, completing and documenting a care coordination assessment on the patient.
- Serves as a liaison to patient, family, admitting, primary care physician, healthcare team, and hospital departments.
- Completes applicable areas of the patient's discharge instruction sheet and the patient transfer sheet, ensuring case management documentation is current and accurate.
Job Qualifications:
- Graduate from an accredited School of Nursing. Bachelor's Degree in Nursing, preferred.
- Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed.
- Minimum 1 year RN Case Management experience required.
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