Clinical Coordinator / Case Manager

Palm Medical Centers•Port Richey, FL

3d•Hybrid

About The Position

Palm Medical Centers is a rapid growing company currently seeking an experienced Clinical Coordinator with leadership experience to join our team. The Clinical Coordinator performs a variety of tasks and coordinates the plans of care for hospital and nursing home patients, from admission to discharge to ensure the continuation of care is provided effectively and efficiently. Reports directly to: Director of Utilization Management.

Requirements

Proven working experience in case management, mental health care manager or a related job experience
Excellent knowledge of case management principles, management and reimbursement
Previous experience with psychological aspects of care
Effective communication skills
Excellent organizational and time management skills
Familiarity with professional and technical emerging knowledge
Problem solving skills and ability to multi-task
Compassionate with teamwork skills
Knowledge of terminology CPT codes and ICD 10
Minimum 3 years of Clinical Coordinator experience.

Nice To Haves

Bilingual preferred
Knowledge of InterQual or Milliman Care Guidelines preferred

Responsibilities

Admit new clients by reviewing records and applications; conduct orientations.
Communicate the daily tracking of all hospital/nursing home admissions and discharge for both statistical and cost management purposes.
Determine clients' requirements by completing intake interviews; Determine need for therapeutic medical, psycho-social, and psychiatric evaluations, review therapist evaluations, treatment objectives, and plans.
Establish treatment programs by setting schedules and routines; coordinate services being provided; arrange resources- including transportation and escort.
Monitor cases by verifying clients' attendance; observe and evaluate treatments and responses; advocate for needed services and entitlements; obtain additional resources; ability to intervene in moments of crises by providing personal support.
Maintain clients' records by reviewing case notes, logging events and progress.
Communicates with PMC managers on members discharged from inpatient facilities to assure appropriate medical care follow up
Obtain weekly update on all nursing home patients
Communicate potential catastrophic and stop loss patients
Identify patients related to possible subrogation and/or cost allocations
Coordinate the transfers of patients as instructed by the Medical Director or PCP.
Arrange direct admissions to hospitals and placement in nursing homes
Assist PCP in placing patients at SNF
Monitor length of stay (LOS) for both hospital and nursing home patients and make necessary discharge arrangements
Communicate clients' progress by conducting weekly interdisciplinary meetings and evaluations, disseminating results and obstacles to therapeutic team and family, identify treatment influences.
Improve staff competence by providing educational resources; balancing work requirements with learning opportunities; evaluating the application of learning to changes in treatment results.
Improve treatment results by studying, evaluating, and re-designing processes, implementing changes, rewriting policies and procedures.
Improve financial status by analyzing results, monitoring variances, identifying trends, and recommending actions to management.