Care Coordinator

Elevance Health•Nashville, TN

1d•$20 - $31•Remote

About The Position

Care Coordinator Shift: 8:30 am to 5:45 pm PT Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Care Coordinator is responsible for coordinating the delivery of care for members. Responsible for reviewing Nursing clinical notes and approving Invoices for Nursing Agency payments. How you will make an impact: Nursing Invoice reviews. Nursing contract criteria validation. Clinical note reviews. Implements, coordinates, monitors, and evaluates options and services to meet member's health needs and ensures appropriate use of clinical resources. Monitors delivery of care across all markets. Maintains daily admissions and discharge records. Expedites and coordinates appointments for assigned hospitalized patients. Authorizes and coordinates services. Keeps all providers involved with member's care updated on appointments, condition, and additional clinical support needed. Requests and gathers necessary medical records. Maintains accurate and complete documentation in Case Management database.

Requirements

Requires a H.S. diploma or equivalent and a minimum of 2 years of experience in Case Management Care Coordination in an HMO environment; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

Medical Assistant Certification.
Intermediate knowledge of Excel.
Experience with Nursing Contracts.
Experience with People Soft.
Experience with CareTend.
Experience working high volume of Nursing Invoices.
Specialty Medication experience.
Experience with Nursing contracts.

Responsibilities

Nursing Invoice reviews.
Nursing contract criteria validation.
Clinical note reviews.
Implements, coordinates, monitors, and evaluates options and services to meet member's health needs and ensures appropriate use of clinical resources.
Monitors delivery of care across all markets.
Maintains daily admissions and discharge records.
Expedites and coordinates appointments for assigned hospitalized patients.
Authorizes and coordinates services.
Keeps all providers involved with member's care updated on appointments, condition, and additional clinical support needed.
Requests and gathers necessary medical records.
Maintains accurate and complete documentation in Case Management database.