Clinical Home Infusion Coordinator Lead
3 weeks ago
Responsibilities:
- Coordinate short-term care plans with members, physicians, facilities, and home infusion vendors.
- Assess site of care utilization and ensure continued medical necessity reviews for prior authorization.
- Communicate with MD offices regarding site of care programs.
- Track and contact MDs providing scope drugs in higher-level care settings than necessary.
- Transfer members from higher levels of care to Home/Ambulatory Infusion Suites for optimal outcomes.
- Create Medical Drug dashboards reporting volumes and costs.
- Identify and implement cost-saving strategies by shifting patient site of service.
- Develop, facilitate, and communicate discharge plans with members, physicians, vendors, and case management teams.
Qualifications:
- Graduate of an accredited 2-4 year nursing program.
- Active, unrestricted RN or LPN license in the state.
- Certification as a Case Manager (Preferred).
- 5-10+ years of clinical experience in managed care, preferably including acute care.
- Ability to use data analytics for decision-making and strategy.
- Leadership experience with clinical staff.
- Prior case management experience.
- Excellent communication skills with all audiences.
- Proficient in MS Office applications.
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