Care Coordinator Job Description

Care Coordinator Job Description

4.5
198 votes for Care Coordinator
Care coordinator provides education and training on E/M visit level charging/coding, CPT charging /coding, and ICD-9 coding.

Care Coordinator Duties & Responsibilities

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

Sample responsibilities for this position include:

Under the supervision of the Director or Care Coordination Lead, assist in the development of tools, education and workflow processes to assist the Division(s) in meeting CMS, ACO, EHR eCQM workflows, coding, and Payer quality initiatives
Maintains confidentiality of all PHI information in compliance with HIPPA, federal and state regulations and laws
Perform SNF assessments on patient using clinical skills and appropriate measurement tools such as LiveSafe, OPT, InterQual and CMS criteria upon admission to SNF and periodically through the patient’s stay
Serve as subject matter expert in quality and value based incentive programs from CMS, ACOs, or payers
Ensure all client information, data, progress notes and other information required by the agency is properly recorded in client files or electronic health records
Work across multiple areas within the hospital
Perform utilization reviews
Support and coordinate the activities of assigned Social Workers
Perform multiple tasks based on varying assignments
Perform daily review of inpatient Census to ensure members are receiving care and services in accordance with established clinical guidelines

Care Coordinator Qualifications

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

Licensing or Certifications for Care Coordinator

List any licenses or certifications required by the position: BLS, CCM, CPR, MSW, BS, CM, MA, ACMA

Education for Care Coordinator

Typically a job would require a certain level of education.

Employers hiring for the care coordinator job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Health, Social Work, Education, Psychology, Nursing, Social Science, Counseling, Management, Substance Abuse, Criminal Justice

Skills for Care Coordinator

Desired skills for care coordinator include:

Medical terminology
Billing
Coding
Insurance authorization process
Experience with CPT and ICD-9 coding
TJC
Nurse Practice Act
CMS
NCQA
HIPPA

Desired experience for care coordinator includes:

Coordinate specialty referrals for medical services
Coordinate access to other services such as home health care, durable medical equipment, pharmaceutical, vision, and family planning
Communicate with the Primary Care Provider, Mental Health Care Provider, Case Managers and delegated vendors
Conduct Utilization Management determinations in accordance with Article 49- Utilization Review
Ensure collection and review of required documentation such as HIV verification, Case Management Assessments and Case Management Re-assessments
Review Case Management assessments, clinical documentation, and claims/utilization data

Care Coordinator Examples

1

Care Coordinator Job Description

Job Description Example
Our company is looking to fill the role of care coordinator. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for care coordinator
  • Perform functional assessments of members using clinical skills and appropriate measurement tools
  • Collaborate effectively with the member’s health care team to establish an optimal, transition plan to the most appropriate PAC setting
  • Assist the member in meeting short and long-term goals with regards to their overall well-being
  • Consult with Medical Directors and/or management to resolve any barriers in the patient’s movement along the continuum of care
  • Assess and monitor patient’s appropriateness for care setting (as indicated) according to LiveSafe™ and InterQual criteria for approvals and refer to licensed physicians for next level of care determinations that do not meet criteria to be approved
  • Complete Utilization Management functions for authorizations
  • Coordinate comprehensive post discharge health care and referrals for community based services
  • Advise member for appropriate care coordination
  • Daily review of census and identification of barriers to manage independent workload and ability to assist others
  • Review monthly readmission reports, quarterly and other reports as needed to assist with the identification of opportunities for improvement
Qualifications for care coordinator
  • Ability to lift or move with assistance 30-50lbs
  • Case Management Certification preferred (ie
  • Required intermediate Microsoft Outlook, Word and Excel
  • Bachelor degree in a recognized field of science or learning which is directly related to the duties of the position is required
  • Master’s degree preferred in nursing, health education, public health, social work with macro focus, or related health field
  • Participate in weekly patient rounds
2

Care Coordinator Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of care coordinator. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for care coordinator
  • Monitoring delivery of care across all markets
  • Maintaining daily admissions and discharge records
  • Expediting and coordinating appointments for assigned hospitalized patients
  • Authorizing and coordinating services
  • Keeping all providers involved with member's care updated on appointments, condition, and additional clinical support needed
  • Requesting and gathering necessary medical
  • Maintaining accurate and complete documentation in Case Management database
  • Organizes, plans and prioritizes caseload to optimize care coordination
  • Evaluates discharge planning needs on admission review
  • Obtains consent from patients for continuing care providers
Qualifications for care coordinator
  • BSN preferred, InterQual experience required
  • Michigan RN license required
  • Ability to multi task and prioritize is a daily practice
  • Ability to learn/use Epic, Bed Tracker for daily work
  • Reviews observation patients each day to determine appropriate level of care and patient status
  • Identifies educational needs of patients, families and staff and takes appropriate actions
3

Care Coordinator Job Description

Job Description Example
Our company is growing rapidly and is looking for a care coordinator. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for care coordinator
  • Assist with the coordination of referrals to community agencies for psychosocial services and entitlement services
  • Report to their supervisor any cases of suspected abuse or neglect or patients who may be a danger to themselves
  • Act as a liaison to community agencies and assist in the discharge planning process
  • Attend interdepartmental meetings with Outreach and Home Care staff to facilitate the provision of services
  • Complete all required assessments in GSI and submits an appropriate plan of care with interventions, and goals
  • Participate in supervision, sharing pertinent patient problems, goals, and outcomes
  • Complete all agency, and departmental paperwork requirements within prescribed time frames
  • Implementation – The care coordinator will facilitate and execute specific interventions that will lead to accomplishing the goals established in the plan of care to ensure the member’s health, safety, and welfare
  • Evaluation – At appropriate intervals, the care coordinator will determine the plan of care’s effectiveness in reaching desired outcomes and goals
  • Promotes an Interdisciplinary Care Team (ICT) with the member, physician/primary care manager, family, and other members of the health care or case management team to conduct care management activities
Qualifications for care coordinator
  • One (1) year of experience in a physician practice is preferred
  • Minimum 2-3 years of recent clinical RN acute care experience required
  • Required intermediate Microsoft Office Outlook, Word and Excel
  • Three years nursing experience with at least two years in Case Management or two years in Emergency Medicine
  • Specialty Area of practice qualifications include graduate of accredited School of Nursing
  • Five years nursing experience with at least two years in Case Management or three years in Emergency Medicine
4

Care Coordinator Job Description

Job Description Example
Our growing company is looking for a care coordinator. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for care coordinator
  • Responsible for utilization management
  • Communicates and collaborates with physicians and multidisciplinary teams to ensure appropriate management of resources to attain patients individualized goals in an appropriate and timely manner and appropriate setting
  • Implements an effective discharge plan
  • Hold or be willing to undertake an NVQ/SVQ level 3 in Care
  • Have at least 6 months experience in a Care Coordinator role
  • Health & Safety / First Aid / Food Hygiene / Moving & Handling certificates would be an advantage, as would experience with Cold Harbour systems, care plan writing and accident reporting
  • Actively communicate between all the team members regarding referral recommendations
  • Communicate the plan of care details and progress of its implementation with all of the patient’s providers
  • Establish and maintain a relationship of mutual respect, acceptance, and trust
  • Gather social, personal, environmental, and health information utilizing any relevant electronic health record, as needed
Qualifications for care coordinator
  • Serve as an advocate and facilitator in the coordination of care and services as driven by individualized goals and interventions on the member’s plan of care
  • Collaborates with providers and members/caregivers to define goals, identify gaps in care and work holistically to optimize member wellness
  • Serve as the accountable point of contact for each member enrolled in care coordination, and assumes primary responsibility for oversight and supervision of the care coordination process including support staff contributions
  • Assures the use of an Interdisciplinary Care Team when appropriate to provide care coordination services for members based on identified needs
  • Communication, coordination, and collaboration within the Interdisciplinary Care Team and between the member and providers
  • Collaborate with facility based Care Managers and providers to plan for post-discharge care needs or facilitate transition to an appropriate level of care in a timely and cost-effective manner
5

Care Coordinator Job Description

Job Description Example
Our growing company is looking to fill the role of care coordinator. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for care coordinator
  • Provide technical and administrative support to clinical and behavioral staff, as needed
  • Assist, complete, and submit special projects, reports
  • Serve as a liaison in corresponding and communicating with providers, vendors, contacts, and/or members representatives
  • Produce, format, and edit correspondence and documents
  • Organize a variety of administrative and clinical tasks and prioritizes in order of importance and impact on members and providers
  • Interact with other departments, including Claims, Intake, Enrollment, and Member Services to resolve member and provider issues
  • Coordinates the setup of cases in different CareCentrix applications for HomeSTAR Program referral process
  • Initiates outbound calls to hospitals, discharge planners, physicians, and home health agencies providing education regarding the benefits of the HomeSTAR Program
  • Staffs HomeSTAR referrals with HomeSTAR designated agencies, identifies if a new HomeSTAR agency is needed and alerts network operations of recommended addition
  • Interacts with physician offices to obtain home health orders for HomeSTAR services, monitors compliance of documentation submission and coordinates the retrieval of home health agency nurse documentation and surveys
Qualifications for care coordinator
  • Minimum of three (3) years of experience in social work or healthcare field (discharge planning, case management, care coordination, and/or home/community health experience) is required
  • Familiarity of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
  • Advocate for members at all levels of care
  • Understanding and respect of all cultures and demographic diversity
  • Associates Degree in Nursing required for RNs, or Masters Degree in Social Work or Healthcare-related field, with an
  • Experience in utilization management, quality assurance, home or facility care, community health, long term care or

Related Job Descriptions

Resume Builder

Create a Resume in Minutes with Professional Resume Templates