Care Coordinator-CRM Job

Children's Health - Care Coordinator Careers

Job Number: 50223

Location: Dallas, TX

Date Posted: 12-3-2016

Description:

The Care Coordinator is responsible for coordinating the delivery of care throughout the continuum of care for assigned patient population. Functions include case management, care coordination, utilization management, quality data capture and discharge planning. Applies InterQual criteria to assess medical necessity of admission, continued stay and discharge. The Care Coordinator is a member of the multidisciplinary team and works closely with physicians, staff nurses, social workers, financial counselors, and ancillary staff to actively facilitate those functions associated with moving the patient through an acute episode of care and linkages to community resources, internal resources, and the payer community. Researches, identifies and implements initiatives and opportunities to improve multidisciplinary communication processes.

Responsibilities:

  • Identifies trends/problems related to delivery of care delays and potentially avoidable days through consistent data capture.
  • Application of severity of illness/intensity of service criteria for patients seeking inpatient admission or continued stay
  • Interacts with patients and physicians to explore the most appropriate setting to meet the patient's needs
  • Make referrals to social work when patient or family needs psychosocial intervention to facilitate transition planning.
  • Ensure patient's eligibility for post-acute services is determined within 24 hours of inpatient admission. Serve as consultant and educator to patient and family regarding post-acute service recommendations.
  • Collaborate with on-site payer representatives to advocate for patient's acute care and post-acute needs.
  • Attend daily rounds and participate in setting priorities of patient needs.
  • Collaborate with attending physician to establish treatment milestones to prepare patient and family for transition to lower level of care.
  • Facilitate referrals to the appropriate areas to expedite care, treatment and services.
  • Establish lines of communication with ancillary service managers.
  • Participates in the development, implementation, evaluation, and ongoing revision of clinical pathways and initiatives to improve quality, continuity, and cost-effectiveness
  • Collaborate with Utilization Management, payers and Health Information Management staff to be knowledgeable regarding documentation.

Experience:

  • 3 years of clinical experience, preferably in a pediatric environment
  • Experience in one or more of the following areas: case management, utilization review, home health care and/or discharge planning, inpatient pediatrics, emergency department pediatrics

Education/License:

  • Four-year Bachelor's degree required
  • Current TX RN license

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