Care Management Coordinator

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

As a Care Management Coordinator, you will support the organization and team through securing authorizations, securing approved bed days and organizing the department’s schedule and daily assignments.

This is a remote Florida opportunity with somedays in office at Indian River Hospital.

A caregiver in this position works 8:00am – 4:30pm.

A caregiver who excels in this role will:

• Recommend resource utilization.

• Facilitate efficient Care Management services.

• Monitor compliance with assigned responsibilities, complete daily/weekly tasks and coordinate with patient financial services.

• Conduct InterQual initial and continued stay reviews, initial and continued stay clinical authorization and 7- and 10-day LOS clinical and financial justifications.

• Ensure coverage for 24/7 on-call process and weekend coverage.

• Conduct daily analysis of reports on observation status reviews, daily comparison of anticipated discharges to actual discharges by IM team and attending physician and weekly analysis of assigned tasks of each case manager to ensure completion of Allscripts/ECIN documentation necessary for clinical LOC justification and payer reimbursement.

• Distribute results of reports on the efficiency and completion of Care Management activities with staff for staff input, follow-up and feedback.

• Ensure InterQual and Allscripts/ECIN reports are distributed to each staff member for action to address identified issues.

• Provide daily/weekly reports to the Director of Clinical Process and Risk Management regarding actions taken to assure full compliance with staff performance expectations.

• Coordinate authorizations, initial and concurrent clinical reviews, submission of data to payers and status of Kepro data entry with all assigned case managers.

• Ensure that both Care Management and Patient Financial Staff have documented authorizations in both Allscripts/ECIN and Invision to ensure Hospital payment for care provided.

• Ensures unit/department is staffed to provide adequate coverage appropriate to meet service needs.

• Maintain departmental files to assure competency with all assigned tasks and compliance with applicable regulations and standards.

• Ensure compliance with CMS/Medicare regulations.

• Provide staff training as needed on the access and use of all IT programs including Invision, Allscripts/ECIN, Epic and KEPRO.

• Maintain confidentiality and ensure compliance with CMS/Medicare regulations.

• Documents, circulates and maintains minutes of staff meetings.

• Completes bi-weekly payroll and payroll variance reports as required.

Minimum qualifications for the ideal future caregiver include:

• Knowledge of financial and utilization review software, including ECIN, InterQual and Kepro.

• Two years of hospital care management experience.

Preferred qualifications for the ideal future caregiver include:

• Knowledge of and/or experience with Epic, Wordand Excel.

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/