Care Management Coordinator
USFull-TimeJunior
Salary not disclosed
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Job Details
- Experience
- 2+ years of experience
- Required Skills
- Communication SkillsOrganizational skills
Requirements
- 2+ years of experience in hospital care management or a related clinical operations role.
- Knowledge of utilization review processes and healthcare authorization workflows is required.
- Familiarity with tools such as InterQual, ECIN, Kepro, or similar clinical/utilization review systems.
- Strong understanding of CMS/Medicare regulations and healthcare compliance requirements.
- Excellent organizational skills with strong attention to detail and accuracy in documentation.
- Ability to manage multiple priorities in a fast-paced clinical environment.
- Strong communication and coordination skills with the ability to work across multidisciplinary teams.
- Comfort working with clinical data, reports, and healthcare information systems.
Responsibilities
- Facilitate efficient care management operations by coordinating daily workflows, clinical reviews, and discharge processes.
- Monitor compliance with assigned responsibilities and ensure completion of daily and weekly operational tasks.
- Conduct InterQual initial and continued stay reviews, including clinical authorization and length-of-stay justifications.
- Coordinate with patient financial services to ensure accurate documentation of authorizations and reimbursement-related data.
- Analyze daily and weekly operational reports, including discharge trends, observation status reviews, and documentation completion rates.
- Distribute performance and compliance reports to care management staff and ensure follow-up on identified issues.
- Support staffing coordination, on-call coverage, and workload distribution to meet departmental service needs.
- Maintain departmental records, ensure regulatory compliance, and support CMS/Medicare requirements.
- Provide training and support for clinical and operational systems such as ECIN, InterQual, Epic, and related platforms.
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