Dsnp Clinical Care Coordinator Jobs

Provides psycho-education and community resources to members as needed.

Experience following evidence-based treatment guidelines.

Knowledge of local, state, and federal regulations.

Reviews medical and mental health history to accurately report to outside providers.

Makes recommendations for referrals per guidelines.

Participates in multi-disciplinary clinical consultation meetings as needed for monitoring progress and coordination of care.

Able to navigate healthcare options; care services post-acute offerings, Medicare coverage, billing issues, as well as accessing healthcare resources.

Excellent analytical and problem-solving skills.

Good working knowledge of home health, hospice and palliative care services

Ability to communicate effectively with empathy over the phone and while interacting with others; excellent interpersonal skills.

Assists in admissions process by working closely with the Gentiva branch staff to follow up on patient admission status.

Minimum of 1 year working in a healthcare related field or healthcare call center

Direct service experience working older adult, forensic/re-entry, TAY or adult through previous employment, internships, and/or lived experience.

ASW/LCSW or AMFT/MFT with current BBS registration; and 2 years of social service experience required

Responsible for utilizing Evidence-Based Practice for the designated population/program to assure high-quality results and intended impact.

Responsible for continuously assessing an individual’s risk status including risk-based symptoms, substance use, environment, complex physical conditions, etc, and intervening appropriately.

Assesses strengths and needs in the planning, provision, and documenting of individualized services. Links to resources and advocates for clients.

Works well with others and behaves professionally and ethically while developing professionally.

General Knowledge, Skills & Abilities

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

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

Performs special projects as assigned and prioritized by management.

Opportunities to work from home

Tuition Reimbursement Program including certifications

Collaborates with compliance director, payers and Health Information Management staff to be knowledgeable regarding documentation.

One (1) year of case management experience.

Reviews the ordering of diagnostic testing and outside clinical procedures, alerting treatment team to possible coverage and utilization management issues

Complies with and updates yearly skills review per policy and timely completes requirements needed to maintain position and/or employment at REHAB.

Interacts openly and professionally while supporting management directives and strategic objectives.

Establishes lines of communication with community liaisons, nursing, therapy, PFS and support service managers.

Manages Ambiguity- Operating effectively, even when things are not certain or the way forward is not clear

Manages Complexity – Making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems

Communicates Effectively – Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences

Courage – Stepping up to address difficult issues, saying what needs to be said

Demonstrates Self-Awareness- using a combination of feedback and reflection to gain productive insight into personal strengths and weaknesses

Situational Adaptability- Adapting approach and demeanor in real time to match the shift in demands of different situations

Two years of clinical experience in a hospital, acute care, home health/hospice, direct care or case management required Required

Two years of experience in care coordination or case management required Required

Knowledge of health plan case management, care coordination, or member navigation.

Knowledge and understanding of case management/coordination of care principles, programs, and processes in either a hospital or outpatient healthcare environment.

Medicaid and Medicare Managed Care knowledge.

Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.

Perform other reasonably related duties or cross-cover as needed or as assigned by the immediate supervisor/management level personnel.

Performs on call responsibilities and provides on call services to clients and families as assigned

Strong interpersonal skills with clients, care providers, and team members.

Excellent written and oral communication skills.

Able to manage time well and work efficiently.

Strong attention to detail and organizational skills.

Strong time management skills required. Must be able to prioritize and adhere to competing deadlines while achieving goals

Experience working in a physician office, skilled nursing center, or other healthcare setting

Certified medical assistant or equivalent certification

Entry level knowledge of healthcare and terminology

Basic knowledge of Microsoft applications (Outlook, Word, Excel)

1-3 years of experience in a healthcare office related role

2+ years of case management experience

Participate in QI activities including data collection, tracking, and analysis. Telephonic clinical case management with Medicare population.

Uses Motivational Interviewing and engagement interventions to optimize member participation in case management programs.

2+ years of managed care experience highly preferred

3+ years of direct clinical experience post degree

2+ year of behavioral health or DSNP experience required

Utilizes care management process for goal directed member care.

Prefer a minimum of one (1) year experience in the managed care industry.

Requires strong knowledge of managed care principles and concepts including Health Plan Effectiveness Data and Information Sheet (HEDIS).

Requires knowledge of the standards of practice for coordination of services, and delivery of services.

Requires strong oral and written communication skills.

Requires good problem solving and conflict resolution skills.