- Position Summary
- The Care Coordinator II has shared responsibility for optimizing the use of and reimbursement for hospital inpatient services by participating in the implementation of the hospital's Utilization Management Plan. As directed, this individual will participate in the managed care process, including managed Maine Care (APS), and in the development and documentation of the patient's transition/discharge pan. These duties are designed to support the hospital's mission in the pursuit of excellence in care/service.
- The areas of focus include assisting/conducting admission and continued stay record reviews utilizing approved criteria and querying teams regarding medical necessary and active treatment. The Care Coordinator II will work with the clinical team to articulate and document the discharge plan, updating it as needed and coordinating the discharge planning process. With supervision, this individual will act as a liaison with third party payers/managed care companies. This individual will also apply quality screens to medical records and participate in other data collection activities.
- The Care Coordinator II will support the hospital's Performance Improvement Plan by actively participating in multidisciplinary performance improvement teams. This individual will contribute to the ongoing continuing education programs and effectively communicate with all customers, both internal and external.
- Required Minimum Knowledge, Skills, and Abilities (KSAs)
- Education: Bachelor's degree in Nursing, Social Work or related field required. Master's degree preferred.
- License/Certifications: N/A
- Experience: 5+ years of relevant experience may be considered in substitution. Experience in healthcare required. Psychiatric setting preferred.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow. Our package includes health and dental insurances, paid parental leave, retirement program, generous paid time off, and much more! Our comprehensive array of benefits are competitive, affordable, and include choices that meet specific, but ever changing, needs.
MaineHealth is a not-for-profit integrated health system consisting of eight local hospital systems, a comprehensive behavioral healthcare network, diagnostic services, home health agencies, and over 19,000 employees. It is the largest health system in northern New England and provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire.
With a career at any of the MaineHealth locations, you'll be working with healthcare professionals that truly value the people around them - both within the walls of the organization and the neighborhoods that surround it. We are deeply invested in the wellbeing of our communities and employees. We believe in fostering a work environment of strong commitment, compassionate caring and continuous improvement. Our care - and the science behind that care - is top rate. Join us and your abilities will be challenged and enhanced as you take your career to another level.
Posting ID: 559421227Posted: 2020-06-03