Job Description
The Lead Care Coordinator will provide hands-on expertise to other team members as needed to help ensure that every patient receives the right type of care, at the right time in the right setting, every day. The Lead will oversee a manageable patient caseload and utilize medical necessity screening tools, such as InterQual or MCG criteria, to complete initial and continued stay reviews in determining appropriate level of patient care, estimation of the patient's expected length of stay and securing insurance authorization for services provided. The Lead follows the Case Management process per department policy and as defined in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization Review.Qualifications
Education- Bachelor's Degree Nursing - minimum
- Master's Degree Nursing - preferred
Experience
- 3 years Acute Nursing experience - minimum
- 2 years Case Management experience - minimum
Licenses and Certifications
- RN State License - Upon Hire minimum Issued by the State of California
- Basic Life Support (BLS) - Upon Hire minimum
- Certified Case Manager - 2 years preferred Experience and certification in case management preferred