Patient Care Coordination Associate

2 weeks ago


Visalia, California, United States KAWEAH HEALTH Full time


Kaweah Health is a community-focused healthcare organization dedicated to delivering a wide range of health services to the surrounding region.

With a workforce exceeding 5,000, Kaweah Health is committed to providing advanced medical care and high-quality preventive services through its various healthcare facilities.

Our extensive healthcare network encompasses numerous campuses and offers a full spectrum of health services.

Working at Kaweah Health requires a unique individual. We serve a community with significant healthcare needs, making our contributions profoundly rewarding. Each day, we support individuals facing diverse challenges and in need of compassionate care.

Our mission is to create a positive impact, enhancing the health of our patients, their families, and the broader community.

Benefits Eligible
Full-Time Benefit Eligible

Work Shift
Day (United States of America)

Department
Case Management


The Patient Care Coordination Associate collaborates with RN Case Management staff to collect clinical information to assess the quality and effectiveness of patient care.

Acts as a bridge between RN Case Management and insurance providers by relaying clinical information for evaluation.

Facilitates the planning and implementation of safe discharge strategies in a timely manner while working closely with the multidisciplinary team.


QUALIFICATIONS
Education

Required:
Two years of college or equivalent training/experience in a health-related field

Experience

Required:
Experience in utilization review and/or coding

Knowledge/Skills/Abilities
Familiarity with basic medical terminology is essential.

Strong organizational and multitasking abilities, capable of managing multiple patients and responsibilities concurrently.

Excellent communication and interpersonal skills, enabling effective interaction with patients, families, and healthcare professionals.


Understanding of discharge medication delivery processes and procedures, including coordination with outpatient pharmacies and patients or their families.

Ability to collaborate effectively with interdisciplinary team members and healthcare professionals.

Proficient computer skills, with a preference for experience in electronic medical record documentation. Competent in using Excel for record-keeping.

JOB RESPONSIBILITIES
Essential

Reviews and documents utilization review data for assigned cases to ensure all inpatient records are up-to-date.
Refers any discrepancies to the Case Management team regarding concurrent reviews of medical records. During chart evaluations, is aware of criteria for quality discrepancies. Adheres to Kaweah Health Policy by reporting utilization discrepancies to the Case Management Committee and/or the Performance Improvement department as necessary.

Evaluates medical records for admissions and continued stays using established criteria for appropriateness.

Must also assess all cases transferred in and out of specialized care areas using specific guidelines. Participates in designated Sub Committee reviews.

Notifies the Case Management Team and attending physician of any questionable or denied cases resulting from the review process.

Initiates further actions by following the established Hospital Case Management Plan.
Facilitates and coordinates the placement of patients in suitable long-term care facilities.
Arranges for acute transfers to other facilities when necessary.

Assists the case management team with discharge planning services, which may include coordinating equipment, home care, home health, and transportation services.

Participates in Continuum of Care discussions.
Gathers information on community resources and connects patients, families, and staff to appropriate services.
Handles telephone inquiries, screens calls, and takes messages as appropriate, following hospital protocols.

ADDITIONAL RESPONSIBILITIES:


Participates in the training of newly hired Care Coordination staff, assisting them in understanding departmental functions.

Aids patients with information and reviews of Advance Directives.

Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served in the assigned unit or work area.

Performs other duties as assigned.

Pay Range
$20.38 -$30.57


If you are looking to utilize your skills in a supportive environment that values courage and purpose, this is the right place for you.



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