Clinical Care Coordinator

2 weeks ago


Seneca, South Carolina, United States Prisma Health Full time
Join Our Team as a Clinical Care Coordinator

Inspire Health. Serve with Compassion. Make a Difference.

As a vital member of our healthcare team, the Clinical Care Coordinator plays a crucial role in enhancing patient engagement and ensuring seamless transitions from acute care settings. This position is responsible for collaborating with a multidisciplinary team, including physicians and clinical staff, to deliver high-quality, cost-effective care tailored to each patient's needs.

Key Responsibilities:
  • Collaborative Care Management: Work closely with attending providers to optimize the use of clinical resources, ensuring that patients receive effective and efficient care.
  • Risk Assessment: Identify social determinants of health that may affect patient outcomes and coordinate post-acute care plans with relevant teams.
  • Problem Resolution: Proactively address and resolve barriers to diagnosis or treatment, documenting any delays and advocating for the patient.
  • Patient-Centered Planning: Navigate value-based care models, ensuring that care plans align with the goals of patients and their families.
  • Psychosocial Evaluation: Assess psychosocial risk factors impacting patients and their families, considering their support systems and coping mechanisms.
  • Regulatory Knowledge: Maintain up-to-date knowledge of state and federal regulations affecting care management services in acute settings.
  • Utilization Review: Ensure medical necessity and appropriate levels of care in accordance with established guidelines.
  • Insurance Coordination: Navigate complex compliance and insurance requirements, regularly coordinating with third-party payors.
  • Patient Advocacy: Serve as a resource for patients and families regarding their rights and responsibilities, particularly in cases of care denial.
  • Empowerment: Advocate for patient and family independence in making informed healthcare decisions.
Minimum Qualifications:
  • Education: Bachelor’s degree in Nursing.
  • Experience: A minimum of three years in acute care nursing, with one year in case management preferred.
  • Licensure: Current Registered Nurse license in South Carolina.
  • Certifications: Accredited Case Manager (ACM) or Certified Case Manager (CCM) preferred.

At Prisma Health, we are committed to transforming healthcare for the communities we serve. We seek talented individuals who are passionate about making a difference in the lives of others.



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