Clinical Care Coordinator
2 weeks ago
POSITION SUMMARY:
Accountable for overseeing the clinical management of a community-based long-term care demographic for PruittHealth Premier Dual Eligible Special Needs Plan (DSNP).
Facilitates the advisory and coordination of clinical care throughout the healthcare continuum, collaborating with both community clinical providers and social support programs that assist PruittHealth Members.
Guides patients towards optimal health outcomes by leveraging cost-effective, high-quality resources through the application of care model guidelines and Case Management (CM) Standards of Practice.
Implements suitable interventions to address various physical, psychological, social, and financial challenges in partnership with the patient, PruittHealth Premier, and healthcare providers. This role involves interaction with members in both home and community-based settings.
PRIMARY RESPONSIBILITIES:
Responsibilities may include, but are not limited to the following:
Post-Implementation Duties:
- Conduct comprehensive in-home and telephonic assessments, collecting data from patients and caregivers, and document findings in a clear and thorough manner.
- Formulate a case management care plan for each patient, grounded in a detailed history and clinical record review, incorporating the attending physician's directives, national guidelines, and available social supports, while considering the patient's capacity for compliance.
- Continuously monitor the needs of patients and families, facilitating necessary adjustments to the care plan as circumstances evolve.
- Provide care management and coordination to ensure patients progress through the continuum of care, utilizing the most clinically appropriate and cost-effective resources in accordance with national practice guidelines and CM Standards of Practice.
- Collaborate with the Plan Care Navigator/Member Advocate to integrate social service/support functions into patient care.
- Coordinate hospital activities related to case management and discharge planning.
- Ensure patients have access to a variety of choices, coordination of primary care providers (PCP) and specialists, comprehension of treatment plans and medications, identification of special needs, referrals, and coordination of transitions between care settings.
- Educate patients and provide ongoing emotional support regarding identified risk factors and various topics, empowering them to take an active role in their care.
- Work with pharmacists and patients/caregivers to ensure effective medication therapy management and adherence.
- Execute case management interventions using methods, techniques, behaviors, information, and learning aids that positively influence the patient and their condition.
- Act as an effective liaison among patients, PruittHealth Premier, caregivers, and other community health providers to ensure appropriate clinical oversight and engagement.
- Responsible for scheduling, coordinating, and completing interdisciplinary team meetings with primary care providers, which may include social workers, dieticians, pharmacists, and physician consultants, among others.
- Organize, secure, integrate, and modify resources necessary to achieve the goals outlined in the case management plan, utilizing partnerships with other plan staff as needed.
- Timely creation of quality case management reports documenting the outcomes of CM plan interventions in achieving patient-specific objectives.
- Facilitate benefits preservation through coordination of appropriate levels of care and plan compliance.
- Coordinate recommended treatments with contracted providers to maintain patient benefits and support cost containment objectives.
- Collaborate closely with participants to enhance understanding of available client benefits and local resources.
- Adhere to PruittHealth Premier's goals, objectives, performance standards, and policies and procedures.
- Ensure compliance with quality patient care and regulatory standards within the company's guidelines and RN scope of practice.
- Comply with PruittHealth Premier's confidentiality policy, HIPAA regulations, and state and federal laws.
- Support the highest level of participant-defined quality of life and well-being.
- Identify overall quality improvement initiatives.
- Business travel may be necessary.
- Ability to function in triage and/or disease management roles as required.
- Additional duties as assigned.
KNOWLEDGE, SKILLS, AND ABILITIES:
- Ability to engage with a diverse range of individuals and manage complex situations with a customer service focus.
- Demonstrated creativity, integrity, and initiative.
- Strong attention to detail and follow-up.
- Experience with electronic clinical charting/records.
- Ability to work independently and remain self-motivated in a remote environment.
- Manage assigned caseload as business needs dictate.
- Excellent time management, flexibility, and organizational skills, with the ability to work independently and collaboratively in both office and remote settings.
- Adherence to legal and ethical principles of privacy, confidentiality, safety, advocacy, and accreditation in all case management activities.
- Compliance with internal and external goals/metrics established for the assigned department.
- Position often requires independent planning and prioritization of patient care objectives.
- Strong analytical and problem-solving abilities.
TECHNICAL COMPETENCIES:
- Proficient in computer skills, including Windows, Care Management Platforms, and general Internet use.
- Ability to chart and follow designated workflows in an electronic environment.
- Proficient typing skills.
COMMUNICATION ABILITIES:
- Strong verbal and written communication skills essential for achieving high levels of customer service and satisfaction.
- Excellent interpersonal skills and the ability to function as part of a multidisciplinary team.
- Proficient in communicating, reading, and writing fluently in English.
- Effective analytical and problem-solving skills.
MINIMUM EDUCATION REQUIRED:
- Advanced Nursing Diploma and/or college degree in nursing required.
- Bachelor's degree or higher preferred.
MINIMUM EXPERIENCE REQUIRED:
- At least two years (full-time equivalent) of direct clinical care experience required.
- Minimum of three years of industry experience in a managed care setting, with a focus on utilization review/case management, and at least two years of case management, home care, or hospice experience strongly preferred.
- Minimum of two years of experience with long-term care populations.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
- Licensed Registered Nurse with a current, unrestricted license in the state of practice (Georgia) required.
- Certified Case Manager preferred – mandatory to apply for CCM certification when eligible.
- Current CPR certification.
ADDITIONAL QUALIFICATIONS:
(Preferred qualifications)
- Minimum of Class B driver's license preferred.
As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.
-
Clinical Care Manager
2 weeks ago
Macon, Georgia, United States Atrium Health Full timeHealthcare Coordination SpecialistPosition Overview: Facilitate and support the healthcare providers and interdisciplinary team in managing patient care effectively. Deliver continuous care management services throughout an acute care admission and ensure follow-up care. Improve the quality of clinical outcomes and enhance patient satisfaction while...
-
Clinical Services Representative
4 days ago
Macon, Georgia, United States Piedmont Urgent Care by Wellstreet Full timeJob SummaryPiedmont Urgent Care by Wellstreet is seeking a skilled Clinical Services Representative to join our team at our Macon Occupational Medicine clinic. As a Clinical Services Representative, you will play a vital role in providing exceptional patient care and supporting our clinical staff.Key ResponsibilitiesPrepare patients for and assist with...
-
Clinical Operations Coordinator
7 days ago
Macon, Georgia, United States River Edge Behavioral Health Full timeAbout the RoleRiver Edge Behavioral Health is seeking a highly skilled Clinical Operations Coordinator to join our team. As a key member of our Utilization Management department, you will play a critical role in ensuring the smooth operation of our clinical services.Key ResponsibilitiesCreate and manage batch files for ConnectsRetrieve and process response...
-
Registered Nurse | Patient Care Coordinator
2 weeks ago
Macon, Georgia, United States Atrium Health Full timePosition OverviewThe role of the Registered Nurse as a Patient Care Coordinator is essential in ensuring seamless patient care. This position involves collaborating with healthcare providers and a multidisciplinary team to enhance patient management during acute care admissions and ensuring follow-up care is effectively delivered.Key...
-
Care Coordination Registered Nurse
2 weeks ago
Macon, Georgia, United States Shaker for ChristianaCare Direct Full timeOverview:ChristianaCare is seeking a dedicated Registered Nurse to become a vital part of our Transitions of Care team. This role primarily operates in a remote capacity, with occasional in-person meetings. The selected nurse will oversee the care coordination for patients moving from acute care settings back to their homes.WORK SCHEDULE:Monday to Friday,...
-
Care Coordination Registered Nurse
2 weeks ago
Macon, Georgia, United States Shaker for ChristianaCare Direct Full timePosition Overview:ChristianaCare is seeking a dedicated Registered Nurse to be part of our hybrid Transitions of Care team. This role primarily involves remote work, complemented by monthly in-person meetings. The selected nurse will play a crucial role in managing the care of patients as they move from acute care settings back to their homes.WORK...
-
Licensed Practical Nurse
2 days ago
Macon, Georgia, United States Primecare Home Care Services Full timeJob SummaryWe are seeking a highly skilled and compassionate Licensed Practical Nurse (LPN) to join our team at Primecare Home Care Services. As a vital member of our homecare agency, you will play a crucial role in providing high-quality nursing care to patients in the comfort of their own homes.Key ResponsibilitiesSupervisory Visits and Education: Conduct...
-
Nurse Care Coordinator
7 days ago
Macon, Georgia, United States Atrium Health Full timeJob Summary:As a Registered Nurse with Atrium Health, you will provide professional nursing care for assigned patient(s) in one or more patient care departments according to State Board of Nursing Practice Act, American Nursing Association Code of Ethics and standards of practice and professional performance.You will be responsible for assessment, diagnosis,...
-
Certified Medical Assistant
3 days ago
Macon, Georgia, United States FIRST CHOICE PRIMARY CARE Full timeJob Summary**Job Title:** Certified Medical Assistant - Patient Care Specialist**Job Summary:** We are seeking a highly skilled and compassionate Certified Medical Assistant to join our team at First Choice Primary Care. As a key member of our healthcare team, you will play a vital role in providing exceptional patient care and support to our patients and...
-
Clinical Nurse Supervisor
2 weeks ago
Macon, Georgia, United States Atrium Health Full timeOverviewAbout Medical Cardiology:A specialized 30-bed unit dedicated to managing patients with both acute and chronic cardiovascular conditions. This unit is equipped to handle cases involving congestive heart failure and offers advanced diagnostic and therapeutic interventions for atrial fibrillation and other cardiac dysrhythmias. Additionally, the unit...
-
Clinical Nurse Supervisor
2 weeks ago
Macon, Georgia, United States Atrium Health Full timePosition OverviewThe Clinical Nurse Supervisor is responsible for overseeing the daily operations of a designated clinical unit, ensuring adherence to the guidelines set forth by the State Board of Nursing and the established AMA Code of Ethics. This role involves acting as the Charge Nurse, delivering both direct and indirect professional nursing care...
-
Hospice Patient Care Coordinator
6 days ago
Macon, Georgia, United States Atrium Health Full time**Job Summary:**As a Nurse Care Specialist with Atrium Health, you will provide direct nursing care to hospice patients, including needs assessment and developing, implementing, and evaluating a plan of nursing care. You will provide direct patient care on an ongoing basis in accordance with the Nurse Practice Act and Hospice standards of care.**Key...
-
Clinical Dietitian
4 days ago
Macon, Georgia, United States Select Medical Full timeJob SummaryWe are seeking a skilled Clinical Dietitian to join our team at Select Medical. As a Clinical Dietitian, you will play a vital role in providing high-quality patient care and promoting a positive patient experience.Key ResponsibilitiesDevelop, implement, and monitor Medical Nutrition Therapies to ensure patients receive optimal nutrition...
-
Medical Office Coordinator
6 days ago
Macon, Georgia, United States Georgia Neurosurgical Institute Full timeJob OverviewWe are seeking a highly skilled Certified Medical Assistant to join our team at Georgia Neurosurgical Institute. As a key member of our healthcare team, you will be responsible for providing exceptional patient care and administrative support to our medical staff.Key Responsibilities:Administrative Support: Provide timely and accurate...
-
Surgical Services Nurse Coordinator
2 weeks ago
Macon, Georgia, United States Atrium Health Full timePosition Overview The Surgical Services Nurse Coordinator is responsible for overseeing direct patient care within the realm of invasive surgical procedures. This role involves acting as a facilitator, mentor, and preceptor for nursing staff, ensuring a high standard of care and professionalism. Key Responsibilities Serve as a positive and progressive role...
-
Clinical Care Supervisor
2 weeks ago
Macon, Georgia, United States PruittHealth Corporation, Inc. Full timePosition Overview:As a Licensed Practical Nurse (LPN) in a leadership role, you will oversee nursing operations and ensure the delivery of high-quality patient care within our facility. Join the PruittHealth Corporation, Inc. team, where we prioritize the well-being and safety of our healthcare professionals.Key Responsibilities:Manage nursing staff and...
-
Quality Assurance Technician
7 days ago
Macon, Georgia, United States FIRST CHOICE PRIMARY CARE Full timeJob Summary**About the Role**The Clinical Quality Specialist is a vital member of the Quality Assurance team at FIRST CHOICE PRIMARY CARE, responsible for assisting with the collection of clinical data, quality improvement summaries, reports, and clinical training. This position plays a crucial role in monitoring clinical quality measures and supporting the...
-
Clinical Manager
2 weeks ago
Macon, Georgia, United States Piedmont Macon Medical Center Full timeJob SummaryWe are seeking a highly skilled and experienced Clinical Manager to join our team at Piedmont Macon Medical Center. As a key member of our leadership team, you will be responsible for overseeing the administrative and operational aspects of assigned departments, ensuring the delivery of high-quality patient care and services.Key...
-
Speech Language Pathologist Clinical Fellow
2 weeks ago
Macon, Georgia, United States Soliant Full timeSpeech Language Pathologist Clinical Fellow OpportunityWe are seeking a highly skilled and dedicated Speech Language Pathologist Clinical Fellow to join our team at Soliant Education. As a Clinical Fellow, you will play a vital role in enhancing students' communication skills and overall development in a school setting.Key Responsibilities:Provide...
-
Registered Nurse for Long Term Acute Care
2 weeks ago
Macon, Georgia, United States Supplemental Health Care Full timePosition Overview: Supplemental Health Care is actively seeking a Travel Nurse RN specializing in Long Term Acute Care. This role is designed for dedicated nursing professionals looking to make a significant impact in patient care.Job Responsibilities:Specialty: Long Term Acute CareDiscipline: Registered Nurse (RN)Employment Type: TravelContract Duration: 13...
