Care Coordinator

University of Maryland Medical System•Easton, MD

11d•Onsite

About The Position

The Care Coordinator is responsible for the achievement of optimal health for the patient, access to care and appropriate utilization of resources. The patient’s plan of care will be balanced with their right to self-determination and patient/caregiver choice. The Care Coordinator, with respect to payer requirements, will ensure timely notification and communication of pertinent clinical data to support admission, clinical condition, continued stay and authorization of post-acute services.

Requirements

Graduate of an approved registered nursing program
Current RN license in the State of Maryland
Three years of experience in an acute care hospital
Demonstrated excellent verbal and written communication skills
Demonstrated excellent interpersonal skills
Demonstrated excellent organizational skills
Ability to demonstrate the knowledge and skills necessary to provide care based on the age of the patients served
Knowledge of the principles of growth and development over the life span
Ability to assess data reflective of the patient’s status
Ability to interpret the appropriate information needed to identify each patient’s requirements relative to his/her age specific needs
Ability to provide the necessary care as described in the department’s policies and procedures

Nice To Haves

Experience in case management
Experience in utilization management

Responsibilities

Assess patients for clinical, psychosocial, financial and operational factors that may affect the progression of care.
Stratify patients at risk for over utilization of services and/or in need of care coordination services.
Collaborate with clinical team to reduce inpatient length of stay and reduce readmissions across the organization.
Perform and document appropriate admission and continued stay reviews using current InterQual/Milliman Care Guidelines criteria on assigned patients.
Develop an effective transition plan based on the health care team's assessment, patient choice and available resources.
Actively participate in CTR rounds; interpret, and integrate the patient’s story into the overall multidisciplinary plan of care.
Develop and implement corrective action plans for resolution of complex problematic issues and elevate to management as necessary.
Document appropriately per care coordination policy, ensuring documentation is complementary and contributes to the progression of the plan of care.
Collaborate with Physician Advisor for complex issues related to the medical plan of care.
Actively participate in clinical performance improvement activities as assigned.
Remain current on clinical practice and protocols impacting clinical reimbursement.