12,578 Care Coordination jobs in the United States
Nurse Care Coordination
Posted 6 days ago
Job Viewed
Job Description
Responsibilities
Shift: Casual Part-Time, Days
Job Summary:
The Nurse Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these services.
Essential Duties:
-
Completes and documents discharge planning assessments. Reassess the patient as appropriate and updates the plan accordingly.
-
Facilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members, the patient and/or patient representative and post-acute care providers in accordance with the patient's clinical or psychosocial needs, choices and available resources.
-
Oversees and evaluates the implementation of the discharge plan.
-
Collaborates with the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria.
-
Collaborates with the healthcare team and post-acute service providers to ensure timely and smooth transitions to the most appropriate type and setting of post-acute services based upon patient's clinical needs.
-
Identifies risk for readmission and implements interventions to mitigate those risks for at least a 30-day period.
Qualifications
License/Certification:
-
Current RN license issued by the State of Oregon required.
-
BLS within 3 months of hire.
-
Certified Case Manager, Accredited Case Manager or UM Certification preferred.
Experience:
- Two (2) years acute hospital experience. A Master's degree in Case Management or Nursing is accepted in lieu of 1 year of experience.
Education:
- Associates degree in Nursing. BSN or bachelors in related healthcare field preferred.
#carecoordination
Overview
CHI Mercy Health offers the unique opportunity to grow professionally in a supportive highly rewarding work environment and to satisfy your soul in the surroundings of a breathtakingly beautiful natural setting. More than 100 years after the founding of our organization the core values - Compassion Inclusion Integrity Excellence and Collaboration - that guide our interactions with our patients and each other remain the same. In the welcoming embrace of these nurturing communities you will feel immediately at home.
Roseburg is located on Interstate 5 in Southern Oregon's scenic Douglas County. The community is nestled in a lush forested region known as the 100 Valleys of the Umpqua. In many places you'll find it hard to maintain a healthy work-life/personal-life balance because the pace of one is indistinguishable from the other. Not here. Life never stops here but it slows to an easy welcome pace. A traffic jam means you missed the yellow and have to wait for the next green. A terrible parking space is the one across from the restaurant instead of in front of it. And the three words you may never hear are "Wow that's expensive." Easy is the best way to describe life here. Hard-to-beat works too.
Click here to view the ANTI-RETALIATION NOTICE / Oregon Nurse Staffing Law: SB 469 (
Pay Range
$51.17 - $71.49 /hour
We are an equal opportunity/affirmative action employer.
Nurse Care Coordination
Posted 7 days ago
Job Viewed
Job Description
CHI Mercy Health offers the unique opportunity to grow professionally in a supportive highly rewarding work environment and to satisfy your soul in the surroundings of a breathtakingly beautiful natural setting. More than 100 years after the founding of our organization the core values - Compassion Inclusion Integrity Excellence and Collaboration - that guide our interactions with our patients and each other remain the same. In the welcoming embrace of these nurturing communities you will feel immediately at home.
Roseburg is located on Interstate 5 in Southern Oregon's scenic Douglas County. The community is nestled in a lush forested region known as the 100 Valleys of the Umpqua. In many places you’ll find it hard to maintain a healthy work-life/personal-life balance because the pace of one is indistinguishable from the other. Not here. Life never stops here but it slows to an easy welcome pace. A traffic jam means you missed the yellow and have to wait for the next green. A terrible parking space is the one across from the restaurant instead of in front of it. And the three words you may never hear are “Wow that’s expensive.” Easy is the best way to describe life here. Hard-to-beat works too.
Click here to view the ANTI-RETALIATION NOTICE / Oregon Nurse Staffing Law: SB 469
ResponsibilitiesShift: Casual Part-Time, Days
Job Summary:
The Nurse Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these services.
Essential Duties:
- Completes and documents discharge planning assessments. Reassess the patient as appropriate and updates the plan accordingly.
- Facilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members, the patient and/or patient representative and post-acute care providers in accordance with the patient’s clinical or psychosocial needs, choices and available resources.
- Oversees and evaluates the implementation of the discharge plan.
- Collaborates with the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria.
- Collaborates with the healthcare team and post-acute service providers to ensure timely and smooth transitions to the most appropriate type and setting of post-acute services based upon patient’s clinical needs.
- Identifies risk for readmission and implements interventions to mitigate those risks for at least a 30-day period.
License/Certification:
- Current RN license issued by the State of Oregon required.
- BLS within 3 months of hire.
- Certified Case Manager, Accredited Case Manager or UM Certification preferred.
Experience:
- Two (2) years acute hospital experience. A Master's degree in Case Management or Nursing is accepted in lieu of 1 year of experience.
Education:
- Associates degree in Nursing. BSN or bachelors in related healthcare field preferred.
#carecoordination
Care Coordination Asst
Posted 8 days ago
Job Viewed
Job Description
Join to apply for the Care Coordination Asst role at Virginia Mason Franciscan Health 5 days ago Be among the first 25 applicants Join to apply for the Care Coordination Asst role at Virginia Mason Franciscan Health Get AI-powered advice on this job and more exclusive features. Responsibilities Job Summary: The Care Coordination Assistant role is responsible for supporting critical and time sensitive functions of the Clinical Care Coordination team, including but not limited to managing post acute care referrals, direct communication with patients/families, post acute care agencies, and other key stakeholders. The Care Coordination Assistant performs these duties with a high degree of accuracy utilizing critical thinking skills and in compliance with hospital policies, standards of practice, and Federal and State regulations. Employees are accountable for demonstrating a strong commitment to our organizational values of: Compassion, Inclusion, Integrity, Excellence, and Collaboration. Essential Job Duties The Care Coordination Assistant, under the direction and supervision of clinical staff performs the following functions: Manage timely post-acute care referrals, to assist with length of stay management and mitigation of denials. Communicate and collaborate with interdisciplinary team, patients, and family to facilitate care progression. Ensure post-acute follow-up appointments for identified patients to assist with readmission prevention and ensuring continuity of care. Deliver required patient notifications and letters, and obtain patient or family signatures on required documentation as needed to meet regulatory compliance. Manage transportation referrals as requested. Comply with confidentiality policies, HIPAA regulations, and organizational standards when transmitting protected patient information to external agencies and vendors as needed for placement, payment or referral. Ensure compliance with hospital policies, standards of practice, applicable Federal or State regulations pertaining to their role, and contribute to the identification of opportunities for process improvement. In facility where Care Coordination has responsibility for Utilization Management functions, the Care Coordination Assistant will also be responsible for: Prioritize and manage communications relating to insurance requests, denials and Physician Advisor status recommendations to the appropriate licensed staff member, and documents any related authorizations, denials or status determinations in the designated EMR or software program. Qualifications Required Education and Experience: Associate (two-year) Degree in Business/Health-Related field or High School Diploma with Medical Assistant or Certified Nursing Assistant certificate or experience in a healthcare setting. Bachelor’s degree, LVN/LPN, BSW preferred. At least 3 years previous experience in health care, care coordination, utilization review, discharge planning or similar healthcare setting is required. Medical terminology certificate or ability to pass medical terminology test required. Experience supporting clinicians in demanding and fast paced patient care environments. Intermediate to advanced computer skills required to include Microsoft Office and/or Google Workspace applications including Word, Docs, Excel, Sheets, typing, and data entry skills. Overview In 2020, united in a fierce commitment to deliver the highest quality care and exceptional patient experience, Virginia Mason and CHI Franciscan Health came together as natural partners to build a new health system centered around the patient: Virginia Mason Franciscan Health. Our combined system builds upon the scale and expertise of our nearly 300 sites of care, including 11 hospitals and nearly 5,000 physicians and providers. Together, we are empowered to make an even greater impact on the health and well-being of our communities. CHI Franciscan and Virginia Mason are now united to build the future of patient-centered care across the Pacific Northwest. That means a seamlessly connected system offering quality care close to home. From basic health needs to the most complex, highly specialized care, our patients can count on us to meet their needs with convenient access to the region’s most prestigious experts and innovative treatments and technologies. While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that may include health/dental/vision, FSA, matching retirement plans, paid vacation, adoption assistance, annual bonus eligibility, and more! Pay Range $21.70 - $9.84 /hour Seniority level Seniority level Mid-Senior level Employment type Employment type Full-time Job function Job function Other Industries Hospitals and Health Care Referrals increase your chances of interviewing at Virginia Mason Franciscan Health by 2x Get notified about new Care Assistant jobs in Seattle, WA . Caregiver - 2000 Sign On Bonus for Fully Certified Caregivers Seattle, WA 5,006.00- 7,165.00 13 hours ago CNA Home Health Hospice 5,000 Signing Bonus Certified Medical Assistant and Preceptor ( 5,000 Sign-On Bonus) Seattle, WA 53,700.00- 80,600.00 4 months ago Federal Way, WA 19.00- 20.00 11 months ago Seattle, WA 4,899.00- 7,014.00 1 week ago Certified Medical Assistant - Flexible Hours + Multiple Day Shifts Available 1:1 Caregiver - Paid Training & Multiple Locations! We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr
Care Coordination Specialist
Posted today
Job Viewed
Job Description
Location: UCHealth UCHlth Anschutz Outpt Pavilion, US:CO:Aurora
Department: UCH CO Responder Program
FTE: Full Time, 1.0, 80.00 hours per pay period (2 weeks)
Shift: Days
Pay: $25.80 - $8.70 / hour. Pay is dependent on applicant's relevant experience
Summary:
Provides clients and families with supportive care coordination services related to their health care management, education on chronic disease management and health maintenance, and connection to appropriate community resources.
Responsibilities:
+ Serves clients under appropriate supervision and participates in regular case conferences. Provides outreach and initial contact to potential clients to introduce them to the program and engage them in care coordination services.
+ Maintains individual case records and protects confidential information. Provides education to clients using population-specific criteria. Documents services provided per established guidelines.
+ Coordinates an individualized plan of care with the client and family. Works with primary care providers and other members of the health care team to ensure coordination of services. Coordinates appointments with providers, utilizing transportation resources as needed. Meets clients in their home, at a provider's office, in the hospital, or in the community as part of ongoing support, offering monitoring of care. Provides appropriate follow-up.
+ Serves as a client advocate with local community agencies (as permitted by clients), and provides emotional support. Facilitates access to key resources including information and education related to chronic disease management. Educates and coaches clients and caregivers about self care skills; collaborates with providers to achieve desired outcomes.
+ Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.
Requirements:
+ Bachelor's degree in Public Health, Nutrition, Exercise Science, Health, Wellness, or related field.
+ Preferred: Experience working with under-served populations or in community health programs.
We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives.
UCHealth invests in its Workforce.
UCHealth offers a Three Year Incentive Bonus to recognize employee's contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of three years' employment.
UCHealth offers their employees a competitive and comprehensive total rewards package (benefit eligibility is based off of FTE status):
+ Medical, dental and vision coverage including coverage for eligible dependents
+ 403(b) with employer matching contributions
+ Time away from work: paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence; start your employment at UCHealth with PTO in your bank
+ Employer-paid basic life and accidental death and dismemberment coverage with buy-up coverage options
+ Employer paid short term disability and long-term disability with buy-up coverage options
+ Wellness benefits
+ Full suite of voluntary benefits such as flexible spending accounts for health care and dependent care, health savings accounts (available with HD/HSA medical plan only), identity theft protection, pet insurance, and employee discount programs
+ Education benefits for employees, including the opportunity to be eligible for 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. Other programs may qualify for up to 5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year
Loan Repayment:
+ UCHealth is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program! UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.
UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.
UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.
Who We Are (uchealth.org)
Care Coordination Specialist
Posted today
Job Viewed
Job Description
Location: UCHealth UCHlth MtnCrest Behav Hlth Ctr, US:CO:Fort Collins
Department: PVH MC IP Psych Care Coordinat
FTE: Full Time, 1.0, 80.00 hours per pay period (2 weeks)
Shift: Days
Pay: $25.80 - $8.70 / hour. Pay is dependent on applicant's relevant experience
Summary:
Provides clients and families with supportive care coordination services related to their health care management, education on chronic disease management and health maintenance, and connection to appropriate community resources.
Responsibilities:
+ Serves clients under appropriate supervision and participates in regular case conferences. Provides outreach and initial contact to potential clients to introduce them to the program and engage them in care coordination services.
+ Maintains individual case records and protects confidential information. Provides education to clients using population-specific criteria. Documents services provided per established guidelines.
+ Coordinates an individualized plan of care with the client and family. Works with primary care providers and other members of the health care team to ensure coordination of services. Coordinates appointments with providers, utilizing transportation resources as needed. Meets clients in their home, at a provider's office, in the hospital, or in the community as part of ongoing support, offering monitoring of care. Provides appropriate follow-up.
+ Serves as a client advocate with local community agencies (as permitted by clients), and provides emotional support. Facilitates access to key resources including information and education related to chronic disease management. Educates and coaches clients and caregivers about self care skills; collaborates with providers to achieve desired outcomes.
+ Within scope of job, requires critical thinking skills, decisive judgement and the ability to work with minimal supervision. Must be able to work in a fast-paced environment and take appropriate action.
Requirements:
+ Bachelor's degree in Public Health, Nutrition, Exercise Science, Health, Wellness, or related field.
+ Preferred: Experience working with under-served populations or in community health programs.
We improve lives. In big ways through learning, healing, and discovery. In small, personal ways through human connection. But in all ways, we improve lives.
UCHealth invests in its Workforce.
UCHealth offers a Three Year Incentive Bonus to recognize employee's contributions to our success in quality, patient experience, organizational growth, financial goals, and tenure with UCHealth. The bonus accumulates annually each October and is paid out in October following completion of three years' employment.
UCHealth offers their employees a competitive and comprehensive total rewards package (benefit eligibility is based off of FTE status):
+ Medical, dental and vision coverage including coverage for eligible dependents
+ 403(b) with employer matching contributions
+ Time away from work: paid time off (PTO), paid family and medical leave (inclusive of Colorado FAMLI), leaves of absence; start your employment at UCHealth with PTO in your bank
+ Employer-paid basic life and accidental death and dismemberment coverage with buy-up coverage options
+ Employer paid short term disability and long-term disability with buy-up coverage options
+ Wellness benefits
+ Full suite of voluntary benefits such as flexible spending accounts for health care and dependent care, health savings accounts (available with HD/HSA medical plan only), identity theft protection, pet insurance, and employee discount programs
+ Education benefits for employees, including the opportunity to be eligible for 100% of tuition, books and fees paid for by UCHealth for specific educational degrees. Other programs may qualify for up to 5,250 pre-paid by UCHealth or in the form of tuition reimbursement each calendar year
Loan Repayment:
+ UCHealth is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program! UCHealth provides employees with free assistance navigating the PSLF program to submit their federal student loans for forgiveness through Savi.
UCHealth always welcomes talent. This position will be open for a minimum of three days and until a top applicant is identified.
UCHealth recognizes and appreciates the rich array of talents and perspectives that equal employment and diversity can offer our institution. As an equal opportunity employer, UCHealth is committed to making all employment decisions based on valid requirements. No applicant shall be discriminated against in any terms, conditions or privileges of employment or otherwise be discriminated against because of the individual's race, color, national origin, language, culture, ethnicity, age, religion, sex, disability, sexual orientation, gender, veteran status, socioeconomic status, or any other characteristic prohibited by federal, state, or local law. UCHealth does not discriminate against any qualified applicant with a disability as defined under the Americans with Disabilities Act and will make reasonable accommodations, when they do not impose an undue hardship on the organization.
Who We Are (uchealth.org)
Director Care Coordination
Posted today
Job Viewed
Job Description
Join to apply for the Director Care Coordination role at CommonSpirit Health . *Responsibilities* *Relocation assistance and sign-on bonus available.* The Director's Responsibilities Include: Directs and manages areas including planning, organizing, and directing all activities related to staffing and performance improvement in the delivery of clinical services, such as LOS reduction. Reports needs within the Medical Center and Dignity Health, as well as government and regulatory reporting. Guides Care Coordination activities according to the needs, requirements, and policies of the Medical Center, the affiliated medical groups and health plans, Dignity Health, federal and state agencies, and standard practices of the professions under the director's accountability. Consults and collaborates with other managers, physicians, administration, and community-based healthcare workers regarding care management issues identified through corporate or facility initiatives and current literature. Works closely with all departments at the medical center and post-acute service providers to streamline patient transitions through the healthcare system and into the community post-discharge. *Qualifications* Minimum Minimum of three (3) years of progressive supervisory or management experience in a Case Management, Care Coordination, or Utilization Management department in an acute care hospital. Bachelor's degree in nursing or equivalent experience required. California RN license. Preference for candidates with a national certification in Case Management. *Overview* Dignity Health Sierra Nevada Memorial Hospital is a 104-bed not-for-profit hospital located in Grass Valley, California, providing compassionate healthcare since 1958. As part of Dignity Health, we access regional resources including the Heart & Vascular Institute, Neurological Institute, and Cancer Institute of Greater Sacramento. Our team of 787 employees and 101 medical staff is committed to kindness and compassion in healing. *Pay Range* $68.76 - $99.70 per hour #J-18808-Ljbffr
Care Coordination Manager
Posted today
Job Viewed
Job Description
Responsive recruiter Benefits: Bonus based on performance Competitive salary Dental insurance Opportunity for advancement Paid time off Vision insurance Health insurance Expanding local owners of Right at Home, are seeking a full-time Care Coordinator to help ensure that our clients continue to receive the best possible home care available in northwest Indiana. The Care Coordinator will have four primary responsibilities: (1) provide quality assurance by training caregivers and conducting supervisory visits; (2) conduct comprehensive in-home assessments for clients and prospective clients; (3) create and maintain individualized care plans for our clients (4) assist with scheduling caregivers for appropriate shifts.We value all our employees and we show it in many ways. In addition to a competitive pay package, the Care Coordinator will be eligible for annual bonuses, pay raises, and paid time off. We have a great culture that our entire team loves being a part of. Our business is growing quickly, and the Care Coordinator will have the opportunity to be a part of something very special. RESPONSIBILITIESQuality Assurance / TrainingProvide hands-on skills training to caregivers.Conduct in-home supervisory visits to ensure care plans are up-to-date, appropriate care is being provided, and company policies and procedures are being followed. Communicate with clients and caregivers to ensure care plans are up-to-date, appropriate, and being followed.Conduct pre- and post-shift quality assurance calls with caregivers and clients. Ensure caregivers properly complete and submit care documentation. Review care notes. Notify management of changes-in-conditions and hospitalizations and document and resolve issues.AssessmentsConduct comprehensive in-home assessments with prospective clients and draft customized client care plans.Conduct client re-assessments as needed.Ensure client care plans and supporting documentation are in compliance with state regulations and agency policies.SchedulingSchedule caregivers for appropriate shifts with clients using scheduling software.Adjust schedules as needed based on client needs and caregiver availability. Participate in the on-call rotation for the officeOther ResponsibilitiesPromote a positive image of Right at Home within the office and in the community.Maintain client confidentiality at all times.Other duties as assigned.SKILLS AND ABILITIESIntelligent, hardworking, and great attitude.Self-starter able to work independently using sound judgment.Ability to multi-task and work in a fast-paced environment.Highly organized with the ability to prioritize.Proficient with technology and Microsoft Office, especially Outlook and Word.Strong writing and analytical skills.Former experience caregiving and/or at a home care or home health agency is a plus.Team player with great energy and empathy.REQUIREMENTS AND PREFERENCES3+ years of experience is required. RNs, LPNs will be given preference for this position. Pay will be commensurate with experience and education. Must have a smartphone and be proficient with software required to complete and manage tasks.High school diploma required, college degree preferred.Valid driver's license, current auto insurance, and reliable transportation.Willing and able to travel within northwest Indiana (Lake, Porter & La Porte Counties). Mileage will be reimbursed. Annual TB testing, background check, drug/alcohol screening will be required.Qualified candidates are asked to submit an application and resume. The ideal candidate would also submit a well-written cover letter describing how he or she would be an asset to our companyRight at Home is an equal opportunity employer. All recruitment and employment decisions are made without discrimination because of race, color, religion, sex, marital status, national origin or ancestry, citizenship status, age, physical or mental disability unrelated to ability, sexual orientation, military status or unfavorable discharge from military servicesCompensation: $45,000.00 - $65,000.00 per year We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.Right at Home's mission is simple.to improve the quality of life for those we serve. Our caregivers and care teams are passionate about serving our clients and are committed to providing the personal care and attention of a friend, whenever and wherever it is needed.At Right at Home, YOU will help improve the quality of life for those we serve. If you are:compassionate empathetic reliabledetermined and are focused on others.than you have found the "Right Home"We look forward to working with you and will continuously strive to fulfill our promises!This franchise is independently owned and operated by a franchisee. Your application will go directly to the franchisee, and all hiring decisions will be made by the management of this franchisee. All inquiries about employment at this franchisee should be made directly to the franchise location, and not to Right at Home Franchising Corporate.
Be The First To Know
About the latest Care coordination Jobs in United States !
Director Care Coordination
Posted today
Job Viewed
Job Description
Join to apply for the Director Care Coordination role at CommonSpirit Health 4 days ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Overview Dignity Health Sierra Nevada Memorial Hospital is a 104-bed not-for-profit hospital located in Grass Valley California. The hospital has been providing compassionate quality health care to residents and visitors of western Nevada County since 1958. As an affiliate of the nationally recognized Dignity Health system we ensure the highest standard of health care to our patients and have access to important regional resources throughout the system including the Dignity Health Heart & Vascular Institute, the Dignity Health Neurological Institute of Northern California, and the Dignity Health Cancer Institute of Greater Sacramento. With 787 employees, 101 active medical staff, and 21 Emergency Department beds, Sierra Nevada Memorial Hospital continually implements and upgrades its technology and recruits employees who understand the vital importance of kindness and compassion in the healing process. Responsibilities The Director's Responsibilities Include The Following: Directs and manages areas including planning, organizing, and directing all activities, staffing, performance improvement in the delivery of clinical services (such as LOS reduction). Reports needs within the Medical Center and Dignity Health as well as government and regulatory reporting. Guides Care Coordination activities according to the needs, requirements, and policies of the Medical Center, the affiliated medical groups, and health plans Dignity Health, any Federal and State agencies, and according to standard practices of the professions under the director's accountability. Consults and collaborates with other managers, physicians, administration, and community-based healthcare workers regarding care management issues identified through corporate or facility initiatives and current literature. Works closely with all departments at the medical center and the post-acute service providers to streamline the patient transition through the health care system and into the community post-discharge. We offer the following benefits to support you and your family: Health/Dental/Vision Insurance Flexible spending accounts Voluntary Protection: Group Accident, Critical Illness and Identity Theft Adoption Assistance Free Premium Membership to Care.com with preloaded credits for children and/or dependent adults Employee Assistance Program (EAP) for you and your family Paid Time Off (PTO) Tuition Assistance for career growth and development Retirement Programs Wellness Programs Qualifications Minimum: Minimum of three (3) years progressive supervisory or management experience (for a Case Management, Care Coordination or Utilization Management department) Bachelor's degree in nursing or experience equivalent required. California RN license We prefer candidates with a Case Management national certification. Pay Range: $68.76 - $99.70 /hour Seniority level: Not Applicable Employment type: Full-time Job function: Health Care Provider Industries: Wellness and Fitness Services, Hospitals and Health Care, and Medical Practices Referrals increase your chances of interviewing at CommonSpirit Health by 2x Get notified about new Director of Care jobs in Grass Valley, CA . #J-18808-Ljbffr
AVP Care Coordination
Posted today
Job Viewed
Job Description
*Summary:*The *System Care Coordination Leader* will serve as a pivotal force in optimizing patient care and resource utilization across Nuvance Health. This leader is responsible for providing strategic leadership and operational oversight for a team of utilization review staff, denials and appeals specialists, non-clinical support staff while partnering with local case management leadership. This individual will support the pursuit of excellence in care coordination, discharge planning, resource stewardship, and regulatory compliance, ultimately contributing to improved patient outcomes, reduced lengths of stay, enhanced organizational efficiency, and maximized reimbursement through denial reduction and successful appeals.
The *System Care Coordination Leader* will be responsible for leading a team encompassing utilization review and denials/appeals specialists and will need to foster a culture of collaboration, patient-centered care, and revenue optimization. This leader empowers denials/appeals specialists to meticulously investigate denied claims, prepare comprehensive appeals, and collaborate with clinical staff to ensure successful outcomes. Simultaneously, they drive the development and implementation of evidence-based care pathways, enhancing care transitions and optimizing resource utilization across the entire care continuum.
*Essential Responsibilities *
* *Strategic Leadership & Vision:*
* *Strategic Planning:* Develop and implement a comprehensive, patient-centric vision and strategy for system-wide care coordination, encompassing utilization review (UR), denials management, discharge planning, social work, and non-clinical support staff. Align this strategy with organizational goals, quality metrics, and financial sustainability.
* *Performance Excellence:* Establish clear departmental goals, key performance indicators (KPIs), and robust data-driven metrics to track success across all care coordination functions. Regularly report progress to executive leadership.
* *Culture of Collaboration:* Foster a positive, high-performing team culture that values collaboration, innovation, continuous improvement, and patient-centered care. Mentor and empower staff to achieve their full potential.
* *Organizational Advocacy:* Champion the critical role of care coordination in optimizing patient outcomes, resource utilization, and financial performance. Actively participate in organizational leadership discussions to advocate for resources and support.
* *Utilization Review Committee:*Establish committee to ensure CMS and regulatory compliance.* *Develop and maintain a UM plan to guide the team with detailed processes and procedures. Attend and contribute to the UR committee meetings.
* *Utilization Review (UR):*
* *Proactive UR:* Lead a team of UR nurses to conduct timely and thorough pre-authorization reviews, ensuring medical necessity and appropriate level of care. Develop clinical criteria and guidelines for efficient UR processes.
* *Concurrent Review:* Oversee the concurrent review process, monitoring patient progress, verifying continued need for services, and facilitating timely discharge planning.
* *Post-Acute Care Coordination:* Collaborate with post-acute care providers to ensure smooth transitions of care, prevent readmissions, and optimize patient outcomes.
* *Denials Management & Appeals:*
* *Root Cause Analysis:* Lead a specialized team to thoroughly investigate claims denied for medical necessity on bedded patients, identify root causes (clinical documentation, coding, etc.), and develop corrective action plans to prevent future denials.
* *Appeals Expertise:* Oversee the preparation and submission of comprehensive appeals, ensuring accuracy, clinical validity, and adherence to payer requirements. Monitor appeal outcomes and adjust strategies as needed.
* *Data-Driven Improvement:* Utilize denials data to identify trends, prioritize improvement efforts, and negotiate with payers for fair reimbursement.
* *Physician Advisor Collaboration:* Collaborate with the physician advisor (PA) group and leader to ensure processes and goals are aligned; including peer-to-peer results, observation rates, observation conversion rates, medical necessity outreach, and feedback to the utilization review team on denial outcomes.
* *Discharge Planning & Social Work:*
* *Patient-Centered Planning:* Partner with and provide support to entity specific social workers and discharge planners to develop individualized discharge plans that address medical, social, and emotional needs. Ensure patient/family education and engagement.
* *Resource Navigation:* Provide assistance, as needed, to connect patients with appropriate community resources, support services, and post-acute care options. Address barriers to care and advocate for patient needs.
* *Readmission Prevention:* Collaborate effectively to implement strategies to reduce readmissions through proactive discharge planning, follow-up care coordination, and community partnerships.
* *Non-Clinical Support Staff:*
* *Optimization:* Supervise and empower non-clinical staff (e.g., administrative assistants, data analysts) to support care coordination processes through data management, scheduling, communication, and resource tracking.
* *Efficiency:* Continuously evaluate and refine workflows to maximize efficiency, reduce administrative burden, and free up clinical staff to focus on patient care.
* *Financial Stewardship & Compliance:*
* *Budget Management:* Develop and manage departmental budgets, ensuring cost-effective operations and optimal resource allocation. Track and report on financial performance.
* *Revenue Cycle Optimization:* Collaborate with revenue cycle teams to maximize reimbursement, reduce denials, and capture appropriate revenue for care coordination services.
* *Regulatory Compliance:* Ensure adherence to all relevant federal, state, and local regulations, accreditation standards, and payer requirements. Maintain up-to-date knowledge of changing healthcare policies.
* Maintain and Model Nuvance Health Values.
* Demonstrates regular, reliable and predictable attendance.
* Performs other duties as required.
**
*Education and Experience Requirements: *
* Bachelor's degree in nursing (BSN)
* Master's degree in nursing, health administration, or a related field preferred
* Current licensure as a registered nurse (RN)
* Minimum of 5 years of clinical experience in an acute care setting
* Minimum of 5 years of progressive leadership experience in case management or utilization review
* Proven leadership experience with a track record of success in managing and motivating teams
* Strong knowledge of healthcare regulations, accreditation standards, and payer requirements
* Excellent analytical, communication, interpersonal, problem-solving, and decision-making skills
* Experience with data analysis and performance improvement methodologies
* Commitment to patient-centered care and interdisciplinary collaboration
* Effective communication and interpersonal skills, with the ability to build relationships with diverse stakeholders
**
*Minimum Knowledge, Skills and Abilities Requirements:*
* Familiarity and competence with Windows applications
* Excellent verbal and written communication skills
* Self-motivation, initiative, and decision making skills
* Effective interpersonal skills which foster a team approach to problem solving and ensure high degree of customer satisfaction
* Ability to act professionally, independently and efficiently
* Demonstration of service excellence and the ability to incorporate the mission and core values into daily activities
* High energy, flexible, optimistic, attitude with ability to handle multiple demands
* Knowledge of third-party payer reimbursement and denial management
* Experience in applying and utilizing InterQual and/or Milliman Care Guideline criteria for patient status determination
* Experience with a healthcare software system including EMR (clinical and financial) is highly desired**
**
*License, Registration, or Certification Requirements:*
* CT or NYS RN License
Working Conditions:
Manual: significant manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Credentials: RN
Company: Nuvance Health
Org Unit: 1822
Department: Rev Cycle Admin
Exempt: Yes
Salary Range: $78.97 - $146.65 Hourly
We are an equal opportunity employer
Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation or our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at (for reasonable accommodation requests only). Please provide all information requested to ensure that you are considered for current or future opportunities.