Clinical Care Coordinator
1 day ago
Apree Health is seeking a skilled Clinical Care Coordinator to join our clinical support team. As a Clinical Care Coordinator, you will play a vital role in condition management services, with a focus on Complex Case Management.
Responsibilities:- Ability to understand the impact of high and rising risk populations on the total cost of care
- Utilize systems and tools provided to identify individuals in need of gap closure, care coordination, and follow-up activities
- Address overutilization of ED services and provide level of care steerage and education
- Assess and participate in care team meetings to ensure appropriate clinical care, support programs, coaching, and case management programs are being utilized
- Participate in wellness outreach and services to encourage preventive health screenings and health maintenance
- Provide education related to disease states, treatment options, lifestyle modifications, and health literacy when needed
- Collaborate with Care Guides to assist patients with benefits education, referrals, billing & claims, eligibility, and digital platform concerns
- Provide RN Triage per established guidelines
- Compliance with all confidentiality protocols and applicable laws
- Document accurately and thoroughly, adhering to all good documentation practices
- Must be eager to receive and apply routine feedback for continuous improvement as a result of call and case documentation reviews
- Receive escalations for medically complex needs and questions
- Other duties as assigned
- Minimum 4-5 years of relevant clinical experience
- BSN or MSN preferred
- Unencumbered registered nursing license with at least a compact license with intent to complete state licensure in 50 states plus the District of Columbia
- Experience in a multi-channel healthcare support environment a plus
- Experience in case management, care management, or clinical coordination a plus
- Multiple system experience including EMR, Salesforce, and Google suite
- Willing to provide a list of required information for our credentialing process
- Knowledge of insurance standards and the payer/provider relationship including referral management, prior authorizations, and medical necessity documentation
- Familiarity with HEDIS and STAR quality measures and gap closures preferred
- Requires being at a desk for extended periods of time
$85k-$104k/annual salary (national average, premium markets may vary)
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