Home Health Clinical Care Coordinator

Job Title/Position: Clinical Care Coordinator

Reports To: Director of Patient Care Services

JOB DESCRIPTION SUMMARY

The Clinical Care Coordinator is responsible for performing professional administrative duties related to the coordination of care. They perform administrative duties such as coordinating care teams for patients and acting as a liaison between patients, patient families, and health care professionals. They are also responsible for auditing, assessing, and participating in the organization's performance improvement and regulatory compliance activities. This position reports to the DPCS.

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES

• Review all Medicare and other episodic payers' clinical records at the local level to assure appropriate documentation for compliance with the regulation. This review includes verification of appropriate documentation, quality of care provided, visit utilization, appropriate contacts with physicians, adherence to the care plan, and evidence of communication between disciplines.
• Review clinical records and files to comply with Conditions of Participation (COPs), using measurements, as licensure, certification, and accreditation results.
• Audit charts for clinical compliance and adherence to the Medicare guidelines.
• Identify clinical problem areas and document deficiency trends in a proactive approach.
• Responsible for managing patient census with the goals of improving compliance, patient care/outcomes, and business partners' experience through efficient and timely communication to ensure timely care, goal completion, documentation compliance, and the transition to outpatient mobile rehab services when appropriate. The LVN Case Manager will also be responsible for providing reports to administrative staff and business owners.
• Assist with quality improvement and Medicare compliance training program. Utilize the organization's approved reference materials to resolve inadequacies.
• Communicate with the Director of Patient Care regarding identified trends of deficiencies with Medicare Conditions of Participation, clinical care, coordination of care, and documentation for the purposes of requiring more extensive education or action of clinical staff.
• Collaborate with the Director of Patient Care, Quality Manager, and clinical associate staff in resolving complex clinical issues and ensure timely care, goal completion, documentation compliance
• Participate in the initial orientation of field staff regarding Medicare Conditions of Participation and relevant requirements for care and documentation and provide education during the orientation in the timeliness of paperwork and flow of OASIS.
• Collaborate with the Director of Patient Care to analyze Performance Improvement trends in the delivery of care. Keep up with the performance indicators and monitor the Performance Improvement plan for the organization.
• Review OASIS documents for accuracy and completeness prior to locking and submitting data electronically.
• Assist with the educating and mentoring of clinicians one on one (in person or over the phone) regarding concerns, questions, the accuracy of OASIS data, and other related documents that are being reviewed.
• Additional duties/tasks may be required, as deemed necessary.

POSITION QUALIFICATIONS

Unrestricted Licensed Vocational Nurse or Registered Nurse

Minimum of 2 years home health experience; two years of home health care experience in Quality Assurance, preferred.

Working knowledge of Medicare home health requirements

Analytically inclined and detailed oriented to ensure proper and accurate review of the clinical chart.

Strong oral and written communication skills and interpersonal skills

Maintains confidentiality of employee and patient information

Promotes quality, comprehensive services through a team approach

Excellent interpersonal communication and organizational skills

The candidate must have good basic telephone and proficient computer skills (email, excel, word, etc.).

Job Type: Full-time

Pay: $75,000.00 - $85,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Ability to Commute:

• San Diego, CA 92123 (Required)

Work Location: In person