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Clincal Care Coordinator II in REMOTE at One Call

Date: 1/9/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    REMOTE
  • Job Type:
  • Experience:
    Not Specified
  • Date:
    1/9/2019

Job Description

Clincal Care Coordinator II

Provides support to the carrier in coordination of workers’ compensation patients until the case is closed by the carrier and/or discharged by the physician.


GENERAL DUTIES & RESPONSIBILITIES:
  • Manages the completion on any portion of process that Care Coordinator was unable to complete, if any.

  • Facilitates flow of evaluation(s), orders, and progress notes from provider(s) to Nurse Case Manager or adjuster per One Call Care Management’s nursing department protocol.

  • Reviews MD orders, initial assessments/evaluations and progress notes on patient, and communicates with provider and carrier per One Call Care Management’s Nursing department procedure to provide updates and ensure progress of patient.

  • Locates provider(s) or contact established provider(s) to arrange additional service for current patient.

  • Communicates with Nurse Case Manager/adjuster and/or provider to ensure appropriate physician orders are obtained and followed.

  • Contacts Nurse Case Manager or Adjuster to obtain authorization for additional or continued service(s).

  • Creates purchase order(s) per One Call Care Management’s nursing department procedure to authorize additional or continuation of service(s) to provider.

  • Utilizes appropriate tracking tools, i.e. authorization logs, Outlook Calendar or Task function, to ensure follow-up on critical timelines as outlined in One Call Care Management’s nursing department procedures for obtaining evaluations/notes, tracking authorizations, and contacting carriers.

  • Coordinates quality assurance issues or concerns involving patient care, retrieval of evaluations and/or notes, and authorization of services closely with assigned Quality Assurance nurse.

  • Maintains thorough, up-to-date documentation on each patient in patient database.

  • Closes file per One Call Care Management’s nursing department procedure once Nurse Case Manager or adjuster cease authorization or physician discharges from home care.

  • Notifies appropriate One Call Care Management’s department(s) of referrals requiring their expertise.

  • Assists in training new associates as requested by Nursing Department Training Leader.

  • Performs special projects as assigned and prioritized by management.


EDUCATIONAL REQUIREMENTS:

Registered Nursing degree; (R.N., L.P.N., or M.A.) with a minimum of two (2) years of experience in acute setting, home care, or front and back medical office.


GENERAL KNOWLEDGE, SKILLS & ABILITIES:
  • Knowledge of the company’s products, services and business operations to enable resolution of customer inquiries

  • Excellent customer service skills that build high levels of customer satisfaction

  • Excellent verbal and written communication skills

  • Computer navigation and operation skills

  • Demonstrates effective people skills and sensitivities when dealing with others

  • Ability to work both independently and in a team environment


Clinical Care Coordinator II

Intermediate role. Moderate skills with high level of proficiency. Responds to a high volume of inquiries about One Call Care Management’s products and services. Questions and issues are predominantly routine, but associate must be able to deviate from standard scripts and procedures as needed. Is able to effectively calm upset customers and end a negative situation positively. May coach and share information with professionals with less experience and/or expertise. Works under close to general supervision with little latitude for independent judgment. May consult with senior peers and team leads to learn through experience. Typically requires two or more years of experience in a call center or customer service-related position in a service industry. One or more years of workers compensation experience is preferable. Associates at this level are expected to meet or exceed established quality and productivity metrics and handle multiple lines of service. 

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