Clinical Care Coordinator (Teen Health)


Charlotte, NC

What you'll be doing

The clinical care coordinator (teen health) facilitates patient progression throughout the continuum. Works collaboratively and maintains active communication with physicians, nursing, and other members of the multidisciplinary care team to effect timely, appropriate patient management. Identifies and resolves delays and obstacles to discharge. Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge. S/he performs utilization management and quality screening for assigned patients utilizing interqual and milliman criteria. Applies approved utilization acuity criteria to monitor appropriateness of admissions and continued stays, and documents findings based on department standards. Identifies at risk populations using approved screening tool and follows established reporting procedures. The incumbent monitors los and ancillary resource consumption on an ongoing basis. The candidate takes action to achieve continuous improvement in both areas. Refers cases and issues to physician advisor in compliance with department procedures and follows through as indicated. This position discusses pay or criteria and issues on a case-by-case basis with clinical staff and follows up to resolve problems with payers as needed. The applicant communicates as needed, with patients to insure understanding of third party pay or guidelines. The role communicates with payer when indicated regarding denials, peer-to-peer (md) needs, and additional clinical requests.

What your background should be

Current rn licensure required. Bsn required. Basic life support for healthcare provider (bls hcp) from aha required. Greater than 2 years clinical, um, discharge planning, home care, ambulatory experience required. Obtain and maintain certificate in ccm or acm within 2 years of employment. Frequent verbal and written communication in english required. Intact sight and hearing with or without assistive devices is required. This job requires some physical demands.

Required Schooling / Training

Not specified

Who is the client company

The client is a nonprofit hospital network which operates hospitals, freestanding emergency departments, urgent care centers and medical practices.
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