Lead Nurse Care Coordinator
About The Position
Are you a seasoned Registered Nurse ready to take your leadership skills to the next level? Join us as a Lead Care Coordinator , where you’ll play a vital role in shaping patient care and driving quality outcomes. In this position, you’ll serve as the primary liaison with insurance payers, ensuring compliance with key quality metrics and building strong partnerships that support exceptional care delivery. You’ll lead a team of Care Managers, guiding them to provide patient-centered, high-quality care while navigating the complexities of managed care systems. If you’re passionate about improving healthcare standards and thrive in a dynamic environment, we want to hear from you!
Requirements
- Current state Registered Nurse or LPN license as required by location.
- Registered Nurse experience—Two years of experience with adult medicine and pediatric patients in primary care/ambulatory care, home health agency, skilled nursing facility, or hospital medical-surgical setting, within the past three years.
- LPN experience—a minimum of five years’ primary care practice experience with adult medicine and pediatric patients in a primary care/family practice setting.
Nice To Haves
- Care management experience preferred.
Responsibilities
- Guide and mentor a team of care coordinators to deliver high-quality patient care.
- Ensure the team adheres to best practices and organizational policies.
- Develop patient-centered care strategies that meet individual health needs and comply with insurance requirements. This involves collaborating with patients, families, and healthcare providers to create effective care plans.
- Act as the primary liaison with insurance payers, ensuring that all patient care services are pre-authorized and reimbursed efficiently. Maintain a deep understanding of insurance processes to resolve any issues promptly.
- Regularly assess care plans and outcomes to ensure compliance with insurance guidelines and healthcare regulations. Utilize analytics to improve care processes and patient satisfaction.
- Establish strong communication channels between patients, providers, and insurance representatives. Resolve any coordination challenges that arise to ensure seamless service delivery.
Benefits
- Health, dental, and vision insurance options
- Paid vacation, sick time, and holidays.
- Bereavement leaves, FMLA, and other leave options
- Employer 401(k) options
- Tuition reimbursement options
- Life, disability, and other insurance options
- Many other amazing benefits
- Full benefits at Prime Healthcare: https://www.primehealthcare.com/careers/benefits/
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees
