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Clinical Care Coordinator I in Jacksonville, FL at One Call

Date Posted: 6/14/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
    Other
  • Experience:
    Not Specified
  • Date Posted:
    6/14/2018

Job Description

Clinical Care Coordinator I

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

PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENTS:
  • For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear
  • For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands and fingers, speak, and hear
  • The employee is occasionally required to stand, walk, and lift objects (up to 10 lbs. weight; up to 4 ft. height)
  • Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus
  • The work environment utilizes florescent lighting; noise level is moderate
  • The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload
  • Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position
  • Please be advised the job description is subject to change at any time

Clinical Care Coordinator I

Entry level role. Basic skills with moderate level of proficiency. Generally performs a high volume of basic inquires about One Call Care Management's products and services by following standard scripts and procedures. Works under close supervision without latitude for independent judgment. Consults with senior peers and team leads on non-complex issues to learn through experience. Typically requires zero to one year of experience in a call center or customer service-related position in a service industry. Zero- 2 years of experience in the workers compensation industry. Associates will handle one service line or more and will become knowledgeable in these areas before moving into a level II role.

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