Director of Care Coordination

Responsibilities

• Facilitates daily care coordination meetings to ensure care resources are aligned with benefits and patient needs
• Participates and facilitates Engage/72 HR Admission meeting
• Ensures coordination as part of the care management system
• Responsible for the coordination of the restorative nursing program including integration of the activity department
• Ensures timely communication with the patient/family regarding changes in condition and discharge planning
• Manages all initial reviews, interim reviews and discharge reviews (Managed Care authorizations/reauthorizations)
• Collaborates with clinical team in the development and execution of care plan
• Serves as a skilled care documentation specialist ensuring that Medicare and Managed care regulatory guidelines are completed accurately and timely
• Reviews Additional Documentation Requests (ADRs) with Health Information Management Coordinator (HIMC) to ensure all documents are available and meet the request

Qualifications

• Degree in nursing, therapy or other related clinical field (i.e. social services), must hold a current license in respective field
• Knowledge of healthcare reimbursement, utilization management, and discharge planning
• Experience providing strategic leadership, managing teams and leading projects required
• Strong verbal, written and interpersonal skills
• Proven ability to lead a team to achieve desired outcomes of team
• Strong communication and organizational skills required
• Must have knowledge of PDPM requirements of insurers
• Understanding of regulatory requirements
• Previous case management experience preferred