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Patient Care Management Specialist

2 months ago

Fort Lauderdale, Florida, United States Cleveland Clinic Full time

About Cleveland Clinic Health System
At Cleveland Clinic Health System, we are committed to shaping a brighter future for healthcare. Each member of our team plays a vital role in our mission to deliver exceptional patient experiences and uphold our standards of excellence.

Position Overview
The Care Management Coordinator is an integral part of our healthcare team, responsible for ensuring efficient care management services. This role involves securing authorizations, managing bed days, and organizing departmental schedules and assignments.

Key Responsibilities
As a Care Management Coordinator, your responsibilities will include:

  • Recommending optimal resource utilization.
  • Facilitating effective care management services.
  • Monitoring compliance with assigned duties and coordinating with patient financial services.
  • Conducting initial and ongoing clinical reviews and justifications for patient stays.
  • Ensuring coverage for on-call processes and weekend duties.
  • Analyzing reports on patient discharge statuses and ensuring documentation is completed for reimbursement purposes.
  • Providing reports to management regarding compliance and performance expectations.
  • Coordinating with case managers on authorizations and clinical reviews.
  • Maintaining departmental files and ensuring compliance with regulations.
  • Training staff on IT systems and maintaining confidentiality.

Qualifications
The ideal candidate will possess:

  • Knowledge of financial and utilization review software.
  • A minimum of two years of experience in hospital care management.

Preferred Skills
Additional skills that will enhance your candidacy include:

  • Proficiency in Microsoft Office applications.
  • Experience with insurance authorizations.
  • Strong communication and organizational skills.

Physical Requirements
This position requires frequent movement between departments and the ability to perform tasks that may involve lifting and carrying objects up to 20 pounds.

Commitment to Diversity
Cleveland Clinic Health System is an equal opportunity employer, dedicated to fostering a diverse workforce.