Clinical Care Coordinator

10 hours ago


Center Line, Michigan, United States LanceSoft Full time
Job Description

At LanceSoft, we are seeking a highly skilled Registered Nurse to join our team as a Clinical Care Coordinator. In this role, you will be responsible for performing prospective, concurrent, and retrospective medical necessity review of post-acute care services to ensure medical necessity for appropriate setting, appropriate length of stay, including appeal requests initiated by providers, facilities and members.

You will coordinate care through the healthcare continuum, including member outreach, and provide support and alternative care support for members not appropriate for post-acute care services. Additionally, you will formulate discharge readiness for members transitioning from a post-acute care setting to a lower level of care.

Requirements:

  • Bachelor's degree in nursing, allied health, business, or related field preferred.
  • Two to four years of clinical experience, including post-acute care, home care, acute patient care, discharge planning, case management, and utilization review.
  • Demonstrated clinical knowledge and experience relative to patient care and healthcare delivery processes.
  • One year health insurance plan experience or managed care environment preferred.
  • Registered Nurse with current unrestricted Michigan Registered Nurse license required.


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