Care Coordination Job Description

Care Coordination Job Description

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Care coordination provides appropriate evidence based patient education, monitors health needs, and coordinates community resources based on patient care needs.

Care Coordination Duties & Responsibilities

To write an effective care coordination job description, begin by listing detailed duties, responsibilities and expectations. We have included care coordination job description templates that you can modify and use.

Sample responsibilities for this position include:

Serve as a resource to physician office on community resources
Create, implement, evaluate and oversee clinical programs designed to improve patient care, reduce costs, and improve health outcomes in collaboration with network team
Educate physicians and their staff on available payer sponsored programs such as complex case management, end-of-life and disease related and encourage appropriate referrals
Audit physician office compliance of clinical records , Health Plan Contracts and retrieve patient file information as needed
Assist patient and family to make follow up appointments with PCP as directed
Educate patients and family on health topics as needed or directed
Respond to physicians and key office staff requests to assist in patient and population management
Attend and facilitate clinical meetings with the health plan contractors as needed
Oversee clinical care rounds with payer and member physician offices
Write articles for newsletter as needed

Care Coordination Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Care Coordination

List any licenses or certifications required by the position: CM, CCM, ACM, NEA

Education for Care Coordination

Typically a job would require a certain level of education.

Employers hiring for the care coordination job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Nursing, Management, Education, Communication, Associates, Health, Medical, Graduate, Social Work, School of Nursing

Skills for Care Coordination

Desired skills for care coordination include:

Medical terminology
Community resources and patient education principles as a case manager
Coding and DRG assignment process
Utilization management principles and payer contracts into patient plans of care
Resources
Levels of care
Utilization Review
Observation status
Available health care and community resources
ACMA

Desired experience for care coordination includes:

Coordinate with Network staff to ensure effective working relationships with physicians and contractors
Utilize electronic record keeping of contacts as required
Lead the strategic planning and development of our Care Management program by driving advancements such as innovations in transitions of care
Mentor, supervise and evaluate a team of more than 20 care coordinators and other assigned staff
Collaborate with multiple service line senior leadership on the implementation of performance improvement initiatives, while acting as the liaison of the Care Management Department
Regularly monitor and assess operations

Care Coordination Examples

1

Care Coordination Job Description

Job Description Example
Our company is looking to fill the role of care coordination. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for care coordination
  • Collect dates/times when the policyholder will be available for the visit to happen
  • Search for nurses in the policyholder's area who are in our network, who can meet the desired availability of the policyholder, to go to the policyholder's home to perform the assessment
  • Source new nurses into our network, as needed, which includes searching, cold calling, negotiating rates, and obtaining signed contracts
  • Confirm the scheduled visit with the policyholder and the FieldScout
  • Send blank assessment documents to the FieldScout and remind them of the visit the day before
  • Follow up with the FieldScout after the visit to ensure timely receipt of the completed documents
  • Communicate with the insurance carrier when there are delays in the process
  • Reschedule visits when necessary
  • Participate in phone queue and fielding inbound calls and updates to cases that may belong to other team members
  • Presents strategic recommendations to leadership based on internal and external drivers and trends, supports strategic initiatives, and effectively manages and completes strategic objectives and department priorities
Qualifications for care coordination
  • Conducts needs analyses, identifies gaps, and develops program components to mitigate identified gaps
  • Creatively and innovatively designs, develops, implements, evaluates and revises Case Management programs to incorporate current research and evidence based best practices, ensuring optimum outcomes
  • Supports and monitors programs and initiatives at a corporate level to enable facility and division leadership to successfully meet program metrics on an ongoing basis
  • Collaborates with appropriate Case Management leaders to establish toolkits, education/training, communications and reporting capabilities to support and monitor programs successfully
  • Provides ongoing evaluation and assessment of facility practices and industry changes to ensure enterprise remains current in Case management processes, including those related to Care Coordination, Length of Stay, Readmissions, Avoidable Days, ED Throughput, Interdisciplinary Team, and other Case Management programs
  • Strong clinical background with minimum of 5 years acute care nursing experience required, critical care experience preferred
2

Care Coordination Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of care coordination. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for care coordination
  • Monitoring compliance with regulations and ensuring consistent application of regulatory changes
  • Developing and monitoring key performance metrics that support the practice of facility-wide Care Coordination / Care Management
  • Creating an integrated comprehensive Care Coordination / Care Management infrastructure that ensures seamless transitions of care and care coordination for high risk patient
  • Developing and managing the organization’s Care Coordination / Management program and ensuring consistent understanding and application
  • Establishing clear measurable goals and a training and evaluation plan for Care Coordinators / Patient Navigators
  • Establishing the competencies required for each position in the program and a consistent process for evaluating the competencies
  • Reporting to and working closely with the Vice President of Ambulatory Care Transformation and Innovation to ensure the Care Coordination / Care Management program is in line with the facility’s strategic plan and goals
  • Providing recommendations on changes to the programs to ensure they remain competitive with peer organizations
  • Maintain Coordination of Care notebooks and Home Health referral list on a daily basis
  • Update and report referral issues to the CBA Director/DON or Director of Client Care at least weekly
Qualifications for care coordination
  • Experience within a health care setting is preferred within an healthcare insurance experience
  • Microsoft products preferred
  • Demonstrates proficiency in MS Office Suite
  • Demonstrates proficiency in using and troubleshooting issues with office equipment
  • 5 years Care Coordination experience and or relavant acute care experience
  • Effective communication skills, especially with medical staff
3

Care Coordination Job Description

Job Description Example
Our company is hiring for a care coordination. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for care coordination
  • Leads human resources areas, such as staff coaching/mentoring, development, competency, and productivity
  • Maintain the hospital list
  • Receive notification of clients admitted to a facility and/or home health
  • Prepare and present written reports to appropriate staff after each case conference meeting
  • Receives incoming reports and calls from home health case managers and communicate information to appropriate staff
  • Backup nurse for Special Attendant orientations
  • Make field visits, as needed
  • Take call on a rotation basis
  • Act as escalation point for issues with other departments
  • Monitor utilization of process guidelines and project management tools by consultants
Qualifications for care coordination
  • Minimum of 5 years case management leadership experience required
  • Comprehensive knowledge of care management and discharge planning, Medicare and Medicaid admission and
  • Review requirements, and general commercial admission and review requirements
  • Minimum of 3 years in a Care Coordination or Case Manager role
  • Current manager or supervisor experience within the last 3 years
  • Sufficient education to attain LVN licensure
4

Care Coordination Job Description

Job Description Example
Our growing company is hiring for a care coordination. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for care coordination
  • Build and manage relationships with key executives and staff at client sites to ensure the success of the engagement(s), including maintenance of engagement through communication and project management/coordination with assigned clients and stakeholders
  • Assist with the development of a market research and sales strategy for health plans, healthy systems and major medical groups in the U.S
  • Develop, update and disseminate knowledge documents related to areas of expertise, such as care coordination, managed care, organizational excellence, revenue cycle, strategic planning and clinical integration
  • Represent the company, and client(s) as appropriate, at various professional networking, public relations, business development and fundraising events
  • Identifies or develops department-wide or individual learning initiatives that cost-effectively focus employee development toward achievement of organizational individual professional and career goals
  • Develops cross continuum orientation and training programs for care management staff
  • Conducts, documents, and communicates thoughtful analyses and monitoring of training needs
  • Creates and monitors project plans to design and deliver world-class learning programs leveraging technology where appropriate to extend access, gain efficiency and scalability
  • Creates standardized performance and evaluation measures across care management teams
  • Develop relationships with the interdisciplinary team members, not limited to, providers, nurses, social workers, and rehabilitation teams to enhance learning opportunities for care management department
Qualifications for care coordination
  • CBA and PHC knowledge and understanding preferred
  • LVN license
  • Experience with multiple clinical management systems
  • Requires direct patient care
  • Requires extensive walking, telephone use, bending, reaching, and lifting items weighing twenty pounds or less
  • Must be able to work well under pressure and maintain professional demeanor under adverse conditions
5

Care Coordination Job Description

Job Description Example
Our growing company is looking for a care coordination. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for care coordination
  • Documents outcome of the Physician Advisor secondary review indicates that the patient does not meet inpatient admission/observation status or continued stay medical necessity criteria
  • Articulates well organized, compelling, appropriate, and innovative recommendations for learning solutions
  • Implements quality and performance initiatives for the care management department based on ongoing analysis of training outcomes and feedback from staff and interdisciplinary team
  • Conducts training needs assessment, recommending and implementing programs to support key skill areas
  • Leads the implementation of learning solutions by partnering with subject matter experts and stakeholders
  • Functions as a subject matter expert regarding the design and development of innovative learning experiences at an enterprise level
  • Remains current with the industry as it pertains to learning and development
  • Focus of Care Coordination is to engage the consumer in their own recovery process and to empower them to access services within the community to increase their community tenure
  • Ensure that consumers attend the outpatient follow-up appointment within seven/30 days of discharge from facility-based care to fulfill hedis requirements
  • Develop and implement recovery plans with consumers focusing on strengths and personal goals
Qualifications for care coordination
  • Extensive reading, writing, use of pagers, fax machines, computers, and copiers
  • MSN or MSW or Masters In Health
  • Bachelor's degree in Nursing or Health Administration required
  • National Certification in Case Management (ACM, ANA RN-BC Case Management) within 18 months of hire required
  • Self-starter with strong problem resolution abilities and customer relation skills
  • Experience coaching, counseling and mentoring staff

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