Patient Care Coordinator

Job Description Summary

Responsible for coordinating hospice 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 hospice 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 hospice.

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

3. Verifies and obtains all appropriate information for admission including, but not limited to, eligibility/benefits.

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

5. Coordinate the initial care to doctors and the hospice team, ordering of DME, Supplies, Medication as needed

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

7. Promotes maximum third-party reimbursement through price negotiations with managed care organizations within the established financial, credit, and contractual parameters.

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

9. Works with members of the billing team to ensure that managed care customers are billed according to managed care organization agreements.

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

11. Promptly responds to managed care customer’s requests and concerns.

12. Assists in building community, customer, payer and patient perceptions of Calstro Hospice Inc as a high quality provider of services.

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

14. Maintains comprehensive working knowledge of community resources and assists customers in accessing community resources should services not be provided by Calstro Hospice Inc.

15. Scheduling visits for all disciplines, which includes RN, LVN, HA, SC, MSW.

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. Licensed Vocational nurse with current licensure to practice professional nursing in the state.

2. Complies with acceptable professional standards and practice.

3. Knowledge of corporate business management and managed care environment.

4. Demonstrates good communications, negotiation, and public relations skills.

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

6. Must be highly skilled in time management, organization, and communication.

Job Type: Full-time

Pay: $34.00 - 38.00 per hour

Job Type: Full-time

Pay: $34.00 - $38.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• AD&D insurance
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Opportunities for advancement
• Paid sick time
• Paid time off
• Paid training
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• On call
• Weekends as needed

Work setting:

• In-person
• Office
• Outpatient

Experience:

• Customer service: 2 years (Required)
• Hospice: 1 year (Required)

Language:

• Spanish (Preferred)

License/Certification:

• LVN (Required)

Ability to Relocate:

• Vista, CA: Relocate before starting work (Required)

Work Location: In person