Clinical Case Coordinator (FT) Full-time Job
Dec 26th, 2022 at 13:32 Home Health Care Miramar 127 views Reference: 3813Job Details
Clinical Case Coordinator (Nurse preferred).
Job Title: Clinical Case Coordinator.
Department/Location: Administration.
Supervisor: VP Payer Relations.
Exempt (Y/N): Y.
Date Prepared: 10/18/2022.
Date Prepared: 10/18/2022.
SUMMARY:
The Clinical Case Coordinator (CCC) for Vohra Wound Physicians is part of the Payor Relations team. Managed care payers, patients and their families, and physicians lean on us to assist in the coordination and oversight of wound care to effect positive patient outcomes. The CCC will work with other members of the team to assess patient wound care needs by identifying qualified patients and coordinating care. CCC will facilitate multi-disciplinary care coordination including discharge planning to the home through telemedicine. The CCC will work closely with home health agencies, nursing facilities, managed care plans, physicians, and internal partners to effectively transition patients to the next level of care. CCC will assist with patient benefit determination and authorization while creating new lines of care collaboration.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Responsible for patient care assessment, planning, scheduling, implementation, and quality improvement.
- Provide care coordination services to patients through discharge planning, home health care agencies, managed care case managers, and other means to provide timely wound care in multiple settings.
- Organize and prioritize clinical responsibilities.
- May be required to provide case management to a group of patients.
- Consistently looks at current processes and procedures, and identifies and implements areas of improvement.
- Make accurate and ongoing assessments of the patient’s status and respond appropriately collaborating with the treating physician, payer, home health agency, and patient’s PCP as needed.
- Review the plan of care as often as the severity of the client’s condition requires, at minimum every 30 days or more frequently if required.
- Based on ongoing assessment of patient, accurately and completely document care to reflect patient’s needs, patient’s responses to care provided, and progress toward goals as care collaboration with the patient, patient’s family, wound physician, PCP, and payer.
- Report progress based on measurable goals and outcomes.
- Work with payers to increase collaborative efforts to treat the patient population requiring home telemedicine and bedside care.
- Report patient progress in collaboration with payers’ case management departments, including initiatives at a state, region, and national level.
- Perform other duties as assigned.
EDUCATION and/or EXPERIENCE:
- An Associate's Degree in Nursing; Bachelor’s in Nursing preferred.
- Current RN License in Florida.
- At least One year experience as an RN required; Two (2) or more years’ experience preferred.
- Experience as a legal case manager or in a risk utilization department; or social worker experience.
- Experience in home healthcare and geriatric case management completed telephonically at the office and home.
- Have knowledge of various managed care payers (insurance companies) benefits and sources for home healthcare and nursing facility bedside care for Medicare Advantage, Commercial, and managed Medicaid benefit plans.
- Availability to work Monday - Friday standard daytime business hour.
About VohraWound Physicians:
Founded in 2000, Vohra Wound Physicians is the largest wound care specialty practice focused exclusively on the post-acute sector, and the premier provider and employer in wound management. The company provides bedside clinical care to hundreds of thousands of patients annually at nearly 3,000 skilled nursing facilities across 28 states as well as to patients healing at home via telemedicine. Supported by proprietary technologies and extensive, ongoing physician training, Vohra delivers results including a 21-day improvement in healing time and an 88% reduction in wound-related hospitalizations. Our mission: to improve patient outcomes and reduce hospitalizations while reducing costs for facilities and home health partners.Vohra is seeking top doctors across the nation to join our practice. Please contact us today to learn more.www.vohrahysicians.com
Company Description
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