Healthcare Coordinator
3 weeks ago
Job Summary
We are seeking a skilled Healthcare Coordinator to join our team at Health eCareers. As a key member of our healthcare team, you will be responsible for ensuring the continuity of care for our patients through effective communication and coordination with healthcare providers.
Key Responsibilities
- Conduct daily pre-admission, admission, and concurrent utilization reviews to determine appropriate levels of care and readiness for discharge.
- Monitor the progression of the discharge plan and facilitate discussions with multidisciplinary teams.
- Educate other healthcare team members on utilization and care coordination.
- Collaborate with patients, families, physicians, and staff to ensure a smooth transition of care.
- Understand and consistently apply the interpretation and utilization of member healthcare benefits.
- Conduct activities according to all applicable regulatory requirements.
Requirements
- Minimum four years of experience in hospital patient care delivery or completion of a Master's degree in case management.
- Graduate of an accredited school of nursing.
- Registered Nurse License (California) and Basic Life Support certification.
- Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPAA, ERISA, EMTALA, and all other applicable federal/state/local laws and regulations.
Preferred Qualifications
- Minimum two years of experience in utilization review, case management, and discharge planning.
- Bachelor's degree in nursing or a healthcare-related field.
- Masters degree in case management.
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