Clinical Care Coordinator

2 weeks ago

Washington, Washington, D.C., United States V-Tech Solutions Inc. Full time
Job Overview

V-Tech Solutions, Inc. is seeking a dedicated Registered Nurse to enhance our client support services. The ideal candidate will possess a keen attention to detail and a strong commitment to delivering exceptional care to individuals in need within the D.C. region.

Key Responsibilities
  • Oversee a designated caseload as specified by Care Management Leadership.
  • Ensure adherence to contractual obligations and care management standards.
  • Assist in the development and execution of disease management and population health initiatives for our most complex members.
  • Conduct outreach and in-person visits at a frequency determined by the enrollee's stratification level, meeting enrollees and caregivers in various settings.
  • Evaluate enrollees upon enrollment and at regular intervals to identify needs and address care gaps.
  • Monitor utilization patterns and respond promptly in accordance with organizational policies.
  • Collaborate with the Primary Care Provider and multidisciplinary teams to create and maintain comprehensive care coordination plans tailored to each enrollee.
  • Perform routine care coordination tasks with a focus on quality and compliance with company policies and national standards.
  • Engage with the Senior Care Manager to prioritize cases and identify potential risks and utilization issues.
  • Document enrollee interactions and findings accurately and in a timely manner.
  • Maintain confidentiality regarding enrollee-specific information as per company policy.
  • Participate in discharge planning activities, ensuring timely contributions to discharge plans that consider the enrollee and their support system.
  • Communicate effectively and respectfully in both verbal and written formats.
  • Empower caregivers and enrollees to take an active role in their care.
  • Support enrollees and their caregivers in understanding the significance of preventive health services and compliance with health requirements.
  • Assist in scheduling and monitoring compliance with medical and mental health appointments, following departmental protocols for reporting noncompliance.
  • Utilize advanced knowledge of the target population and care management practices to support assigned enrollees.
  • Attend multidisciplinary meetings as necessary, including those with external agencies.
  • Review reports from vendors or contracted providers regarding enrollee services and facilitate necessary follow-up care.
  • Educate enrollees and caregivers on medication management and self-care techniques within the scope of practice.
  • Assist enrollees in planning for transitions of care across various settings.
  • Process authorizations for services requiring approval from Care Management staff.
  • Stay informed about evolving strategies and trends in care coordination and management.
  • Utilize effective communication skills to foster understanding and collaboration among enrollees, families, and healthcare providers.
  • Present accurate information about the organization to enrollees, families, and the community.
  • Maintain a professional demeanor in all interactions, demonstrating a customer-focused approach.
  • Exhibit knowledge of medical terminology and healthcare delivery systems.
  • Employ effective time management and organizational skills.
Qualifications

Education:

  • Associate Degree required.
  • Bachelor's Degree preferred.

Experience:

  • Minimum of two years in healthcare or related fields, particularly in case management or managed care.
  • Experience in public/community health or medical/behavioral health settings is advantageous.

Licensure:

  • Must hold a valid Registered Nurse license in the District of Columbia.

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