Care Coordination Job Description
Care Coordination Duties & Responsibilities
To write an effective care coordination job description, begin by listing detailed duties, responsibilities and expectations. We have included care coordination job description templates that you can modify and use.
Sample responsibilities for this position include:
Care Coordination Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Care Coordination
List any licenses or certifications required by the position: CM, CCM, ACM, NEA
Education for Care Coordination
Typically a job would require a certain level of education.
Employers hiring for the care coordination job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Nursing, Management, Education, Communication, Associates, Health, Medical, Graduate, Social Work, School of Nursing
Skills for Care Coordination
Desired skills for care coordination include:
Desired experience for care coordination includes:
Care Coordination Examples
Care Coordination Job Description
- Collect dates/times when the policyholder will be available for the visit to happen
- Search for nurses in the policyholder's area who are in our network, who can meet the desired availability of the policyholder, to go to the policyholder's home to perform the assessment
- Source new nurses into our network, as needed, which includes searching, cold calling, negotiating rates, and obtaining signed contracts
- Confirm the scheduled visit with the policyholder and the FieldScout
- Send blank assessment documents to the FieldScout and remind them of the visit the day before
- Follow up with the FieldScout after the visit to ensure timely receipt of the completed documents
- Communicate with the insurance carrier when there are delays in the process
- Reschedule visits when necessary
- Participate in phone queue and fielding inbound calls and updates to cases that may belong to other team members
- Presents strategic recommendations to leadership based on internal and external drivers and trends, supports strategic initiatives, and effectively manages and completes strategic objectives and department priorities
- Conducts needs analyses, identifies gaps, and develops program components to mitigate identified gaps
- Creatively and innovatively designs, develops, implements, evaluates and revises Case Management programs to incorporate current research and evidence based best practices, ensuring optimum outcomes
- Supports and monitors programs and initiatives at a corporate level to enable facility and division leadership to successfully meet program metrics on an ongoing basis
- Collaborates with appropriate Case Management leaders to establish toolkits, education/training, communications and reporting capabilities to support and monitor programs successfully
- Provides ongoing evaluation and assessment of facility practices and industry changes to ensure enterprise remains current in Case management processes, including those related to Care Coordination, Length of Stay, Readmissions, Avoidable Days, ED Throughput, Interdisciplinary Team, and other Case Management programs
- Strong clinical background with minimum of 5 years acute care nursing experience required, critical care experience preferred
Care Coordination Job Description
- Monitoring compliance with regulations and ensuring consistent application of regulatory changes
- Developing and monitoring key performance metrics that support the practice of facility-wide Care Coordination / Care Management
- Creating an integrated comprehensive Care Coordination / Care Management infrastructure that ensures seamless transitions of care and care coordination for high risk patient
- Developing and managing the organization’s Care Coordination / Management program and ensuring consistent understanding and application
- Establishing clear measurable goals and a training and evaluation plan for Care Coordinators / Patient Navigators
- Establishing the competencies required for each position in the program and a consistent process for evaluating the competencies
- Reporting to and working closely with the Vice President of Ambulatory Care Transformation and Innovation to ensure the Care Coordination / Care Management program is in line with the facility’s strategic plan and goals
- Providing recommendations on changes to the programs to ensure they remain competitive with peer organizations
- Maintain Coordination of Care notebooks and Home Health referral list on a daily basis
- Update and report referral issues to the CBA Director/DON or Director of Client Care at least weekly
- Experience within a health care setting is preferred within an healthcare insurance experience
- Microsoft products preferred
- Demonstrates proficiency in MS Office Suite
- Demonstrates proficiency in using and troubleshooting issues with office equipment
- 5 years Care Coordination experience and or relavant acute care experience
- Effective communication skills, especially with medical staff
Care Coordination Job Description
- Leads human resources areas, such as staff coaching/mentoring, development, competency, and productivity
- Maintain the hospital list
- Receive notification of clients admitted to a facility and/or home health
- Prepare and present written reports to appropriate staff after each case conference meeting
- Receives incoming reports and calls from home health case managers and communicate information to appropriate staff
- Backup nurse for Special Attendant orientations
- Make field visits, as needed
- Take call on a rotation basis
- Act as escalation point for issues with other departments
- Monitor utilization of process guidelines and project management tools by consultants
- Minimum of 5 years case management leadership experience required
- Comprehensive knowledge of care management and discharge planning, Medicare and Medicaid admission and
- Review requirements, and general commercial admission and review requirements
- Minimum of 3 years in a Care Coordination or Case Manager role
- Current manager or supervisor experience within the last 3 years
- Sufficient education to attain LVN licensure
Care Coordination Job Description
- Build and manage relationships with key executives and staff at client sites to ensure the success of the engagement(s), including maintenance of engagement through communication and project management/coordination with assigned clients and stakeholders
- Assist with the development of a market research and sales strategy for health plans, healthy systems and major medical groups in the U.S
- Develop, update and disseminate knowledge documents related to areas of expertise, such as care coordination, managed care, organizational excellence, revenue cycle, strategic planning and clinical integration
- Represent the company, and client(s) as appropriate, at various professional networking, public relations, business development and fundraising events
- Identifies or develops department-wide or individual learning initiatives that cost-effectively focus employee development toward achievement of organizational individual professional and career goals
- Develops cross continuum orientation and training programs for care management staff
- Conducts, documents, and communicates thoughtful analyses and monitoring of training needs
- Creates and monitors project plans to design and deliver world-class learning programs leveraging technology where appropriate to extend access, gain efficiency and scalability
- Creates standardized performance and evaluation measures across care management teams
- Develop relationships with the interdisciplinary team members, not limited to, providers, nurses, social workers, and rehabilitation teams to enhance learning opportunities for care management department
- CBA and PHC knowledge and understanding preferred
- LVN license
- Experience with multiple clinical management systems
- Requires direct patient care
- Requires extensive walking, telephone use, bending, reaching, and lifting items weighing twenty pounds or less
- Must be able to work well under pressure and maintain professional demeanor under adverse conditions
Care Coordination Job Description
- Documents outcome of the Physician Advisor secondary review indicates that the patient does not meet inpatient admission/observation status or continued stay medical necessity criteria
- Articulates well organized, compelling, appropriate, and innovative recommendations for learning solutions
- Implements quality and performance initiatives for the care management department based on ongoing analysis of training outcomes and feedback from staff and interdisciplinary team
- Conducts training needs assessment, recommending and implementing programs to support key skill areas
- Leads the implementation of learning solutions by partnering with subject matter experts and stakeholders
- Functions as a subject matter expert regarding the design and development of innovative learning experiences at an enterprise level
- Remains current with the industry as it pertains to learning and development
- Focus of Care Coordination is to engage the consumer in their own recovery process and to empower them to access services within the community to increase their community tenure
- Ensure that consumers attend the outpatient follow-up appointment within seven/30 days of discharge from facility-based care to fulfill hedis requirements
- Develop and implement recovery plans with consumers focusing on strengths and personal goals
- Extensive reading, writing, use of pagers, fax machines, computers, and copiers
- MSN or MSW or Masters In Health
- Bachelor's degree in Nursing or Health Administration required
- National Certification in Case Management (ACM, ANA RN-BC Case Management) within 18 months of hire required
- Self-starter with strong problem resolution abilities and customer relation skills
- Experience coaching, counseling and mentoring staff