Rn Coordinator Jobs

About The Position

Requirements

• Licensure as a Registered Nurse in the State of SC.
• A Minimum of three (3) years of recent clinical pediatric experience is required.
• Initial TB negative test and completion of a TB questionnaire, yearly
• Current RN licensure in states where business is conducted.
• Current BLS certification
• Demonstrated computer proficiency with Microsoft Office, electronic health record (EHR/EMR) systems, Medicaid documentation and care management platforms, and the ability to efficiently navigate multiple electronic systems while maintaining accurate, timely, and compliant clinical documentation in accordance with state and regulatory requirements.
• Reliable, high-speed internet service capable of supporting Company applications and video meetings.
• A private, secure workspace where confidential conversations and information cannot be viewed or overheard by unauthorized individuals.
• Ability to maintain compliance with all HIPAA, Company confidentiality, and information security policies.
• Company-issued computer and equipment must be used for all Company business unless otherwise authorized in writing.
• The remote workspace must be password protected and physically secure when unattended.
• Employees must lock their computer whenever stepping away from their workstation.
• Printed documents containing PHI should be avoided whenever possible. If printing is necessary, documents must be secured and properly destroyed using an approved shredder or secure disposal method.
• Family members, roommates, visitors, or other unauthorized individuals may not access Company equipment, systems, or confidential information.
• Employees must immediately report any lost, stolen, or compromised equipment, passwords, or suspected security incidents.
• Employees must comply with all Company cybersecurity requirements, including multi-factor authentication (MFA), password standards, software updates, and antivirus protection.
• Employees are responsible for maintaining a workspace that is safe, free from distractions, and suitable for productive work during scheduled working hours.
• Employees must be available during their scheduled work hours and maintain regular communication with supervisors and team members.
• Absolute confidentiality: Employees must not disclose PHI to unauthorized individuals under any circumstances.
• Secure environment: A private, locked workspace must be maintained to prevent exposure of PHI to family members, visitors, or others.
• Company-approved technology only: All work must be performed on secure, company-issued devices using encrypted connections (VPN required).
• You will be required to complete HIPAA training upon hire and annually thereafter.
• Any breach of confidentiality or unauthorized disclosure of patient information may result in disciplinary action up to and including termination and may carry legal consequences under state or federal law.

Nice To Haves

• A bachelor’s degree in a health-related field is strongly preferred.
• Previous work experience with a Medicaid program is preferred.
• Bilingual (Spanish) is preferred.
• Certified Case Management (CCM) Certification is preferred
• A Bachelor’s degree in a health related field is strongly preferred.
• Certified Case Management (CCM) Certification is required within four (4) years of employment. Other certifications recognized by URAC are also acceptable.

Responsibilities

• Upon referral, perform an initial medical eligibility assessment to determine eligibility for the program.
• If qualified, perform an initial, in-home, level of care assessment to include the completion of all required documentation.
• Fulfills requirements established by SCDHHS to complete an annual home visit, three in person quarterly visits, and monthly contact calls during months a visit is not required.
• Ensuring the information contained in the system of record is accurate and complete.
• Provides members and their authorized representatives with education required to care for members and arranges appropriate education services, if necessary.
• Develops case specific care plans/service plans and presents to the primary care provider for approval and/or revision; submits care plan to DHHS for approval.
• Collaborate with the Care Advocate Team to ensure all required services, communications, documentation, and ancillary needs are addressed.
• Maintains availability to members, their authorized representatives, and providers to coordinate any required services.
• Serve as a member advocate, attending educational advocacy meetings, team conferences, etc. as requested and available.
• Addresses and identifies complaints, grievances, or concerns and escalates to the appropriate stakeholder, when necessary.
• Develops disaster plan, identifies availability of advanced directives, needs for ancillary services, specialty services and community services.
• Upon member ineligibility, age out, or other circumstance in which disenrollment from the program becomes necessary, complete all needed activities to ensure continuation of care and communicate with all stakeholders to ensure an uninterrupted transition of care.
• Serve as a mandated reporter.
• Will have access and manage PHI in accordance with federal and state requirements (HIPAA, HITECH).
• Adheres to the policies and procedures of South Carolina Solutions
• Maintains strict confidentiality of client, company and personnel information
• Demonstrates a strong commitment to the mission and values of the organization
• Adheres to company attendance standards
• Performs other duties as assigned
• Completes all annual training assigned by the deadline for completion
• Will demonstrate successful completion and compliance with all policies and procedures, to be assessed during quarterly performance reviews
• Criminal background, OIG, and South Carolina Exclusion list checks must remain in good standing.
• South Carolina Law Enforcement Division Check must be completed upon hire and every 5 years thereafter.
• Will abide by the Ethical Code of Conduct set forth by the company, to be reviewed and signed yearly.

Benefits

• Mileage is reimbursed for travel.