Job Description

Job Description

Job Description

Job Title/Position: Care Coordinator

 

Reports To: Care Coordinator Supervisor

 

JOB DESCRIPTION SUMMARY

Responsible for coordinating home care services for managed care patients, which includes establishing and maintaining the patient's plan of care, establishing and maintaining positive relationships with managed care customers and related referral sources, and negotiating service agreements.

 

 

ESSENTIAL JOB FUNCTIONS Responsibilities

 

1. Coordinates home care services for managed care patients, assists with the establishment of the plan of care in coordination with the physician and insurance Case Managers, and ensures a seamless transition to home care.

2. Collaborates with inpatient utilization review departments and managed care Case Managers to facilitate safe, early inpatient discharge.

3. Verifies insurance coverage and obtains initial authorizations for services and seeks reauthorization for ongoing and additional services.

4. Works with Clinical Supervisors and staff clinicians to gather, collate, and report patient care summary information to managed care Case Managers.

5. Maintains comprehensive working knowledge of managed care contractual relationships and ensures that patients are admitted and services are delivered in accordance with contract provisions.

6. Works with members of the billing team to ensure that managed care customers are billed according to Case Manager agreements.

8. Establishes and maintains positive working relationships with current and potential managed care customers.

9. Promptly responds to managed care customer's requests and concerns.

10. Assists in building community, customer, payer and patient perceptions of Girling Health Care Of New York, Inc. as a high quality provider of services.

11. Maintains comprehensive working knowledge in the field of managed care and shares information with appropriate organization personnel.

12. Maintains comprehensive working knowledge of community resources and assists customers in accessing community resources should services not be provided by Girling Health Care Of New York, Inc.

 

 

The above statements are intended to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

 

 

POSITION QUALIFICATIONS

1. High school Diploma or GED

2. At least one-three years' experience in health care managed care coordination, preferably in home health care.

3. Complies with acceptable professional standards and practice.

4. Ability to deal tactfully with customers and the community.

6. Great customer service skills and organizational skills

7. Demonstrates good communication.

8. Demonstrates autonomy, organization, assertiveness. flexibility, and cooperation in performing job responsibilities.

9. Can work oncall as needed

 

Languages:

• English speaking a must
• Korean and Spanish a plus

 

Company Description

This is a CDPAP and Elixer Healthcare company.

HCS Home Care provides direct home health care services to patients in their homes 24 hours each day, seven days each week, and every day each year. Our caring staff provides compassionate and loving care to patients of diverse background and patient care needs.

Company Description

This is a CDPAP and Elixer Healthcare company.\r\n\r\nHCS Home Care provides direct home health care services to patients in their homes 24 hours each day, seven days each week, and every day each year. Our caring staff provides compassionate and loving care to patients of diverse background and patient care needs.

Job Tags

Contract work,

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