Clinical Care Coordinator

What you'll be doing: Coordinates/facilitates patient progression throughout the continuum. Works collaboratively and maintains active communication with physicians, nursing and other members of the multidisciplinary care team to effect timely, appropriate patient management. Identifies and resolves delays and obstacles to discharge. Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge. Performs utilization management and quality screening for assigned patients utilizing InterQual and Milliman criteria. Applies approved utilization acuity criteria to monitor appropriateness of admissions and continued stays, and documents findings based on department standards. Identifies at risk populations using approved screening tool and follows established reporting procedures. Monitors LOS and ancillary resource consumption on an ongoing basis. Takes action to achieve continuous improvement in both areas. Refers cases and issues to physician advisor in compliance with department procedures and follows through as indicated. Discusses pay or criteria and issues on a case by case basis with clinical staff and follows up to resolve problems with payers as needed. Communicates as needed, with patients to insure understanding of 3rd party pay or guidelines. Communicates with payer when indicated regarding denials, peer to peer (MD) needs and additional clinical requests.

What your background should be: Greater than 2 years of clinical, UM, discharge planning, home care, ambulatory experience is required. Current RN licensure required. Basic life support for healthcare provider (BLS HCP) from AHA required. Must have good communication skills; interpersonal skills.

Who is the client company: Concern about hospital & health care services.; If you are interested in this position, send your resume to apply@kochdavis.com