RN Clinical Coordinator

Responsibilities

• Admit new clients by reviewing records and applications
• Conduct orientations
• Communicate the daily tracking of all hospital/nursing home admissions and discharge for both statistical and cost management purposes
• Determine clients' requirements by completing intake interviews
• Determine need for therapeutic medical, psycho-social, and psychiatric evaluations, review therapist evaluations, treatment objectives, and plans
• Establish treatment programs by setting schedules and routines; coordinate services being provided; arrange resources- including transportation and escort
• Monitor cases by verifying clients' attendance; observe and evaluate treatments and responses; advocate for needed services and entitlements; obtain additional resources; ability to intervene in moments of crises by providing personal support
• Maintain clients' records by reviewing case notes, logging events and progress
• Communicates with PMC managers on members discharged from inpatient facilities to assure appropriate medical care follow up
• Obtain weekly update on all nursing home patients
• Communicate potential catastrophic and stop loss patients
• Identify patients related to possible subrogation and/or cost allocations
• Cook up the transfers of patients as instructed by the Medical Director or PCPA
• Arrange direct admissions to hospitals and placement in nursing homes
• Aid PCP in placing patients at SNF
• Monitor length of stay (LOS) for both hospital and nursing home patients and make necessary discharge arrangements
• Communicate clients' progress by conducting weekly interdisciplinary meetings and evaluations, disseminating results and obstacles to therapeutic team and family, identify treatment influences
• Improve staff competence by providing educational resources; balancing work requirements with learning opportunities; evaluating the application of learning to changes in treatment results
• Improve treatment results by studying, evaluating, and re-designing processes, implementing changes, rewriting policies and procedures
• Improve financial status by analyzing results, monitoring variances, identifying trends, and recommending actions to management

Requirements

• Proven working experience in case management- including as an RN, medical, mental health care manager or a related job experience
• Excellent knowledge of case management principles, management and reimbursement
• Previous experience with psychological aspects of care
• Effective communication skills
• Excellent organizational and time management skills
• Familiarity with professional and technical emerging knowledge
• Problem solving skills and ability to multi-task
• Compassionate with teamwork skills
• Knowledge of terminology CPT codes and ICD 10
• Bilingual preferred
• Knowledge of InterQual or Milliman Care Guidelines preferred

Minimum Qualifications

• Active TX RN license
• Minimum 3 years of RN Clinical Coordinator experience

Pay

From $75,000.00 per year (negotiable based on experience)

Schedule

Day shift

Monday to Friday

Work Location

Hybrid (In-office, On-site 3 locations)

Ability to commute/relocate

Dallas Area: Reliably commute or planning to relocate before starting work (Required)