Lead, Inpatient Coordinator

Position Summary:

Responsibilities for this position include completing non-clinical tasks related to supporting the Inpatient Care Management Program so that it functions in a smooth and efficient manner and to assist the supervisor and or VP of Inpatient Case Management as needed. This includes ensuring that all necessary clerical functions from the time of hospitalization through discharge, inclusive of required follow-up care are completed accurately and timely by the campus coordinators.  Primary functions include updating and maintaining the hospital daily census and identifying significant coordinator task duty imbalance and reporting such issues to the management team for possible process review. Assist in facilitating hospital provision of required patient information and to support the Inpatient Case Manager

Essential Duties and Responsibilities include the following:

• Assist the Manager of Inpatient Case Management with the non-clinical functions of Inpatient Case Management Department.
• Acts as a resource to the Inpatient Case Management coordinators when supervisor is off premises.
• Communicate with supervisor and VP of Clinical services on a daily basis.
• Train Case Managers and Coordinators to computers systems and Inpatient process.
• Direct calls to the appropriate physicians.
• Summarize all new overnight admission and inform the rest of the clinical team by 9am.
• Open cases for admission accurately and timely for assigned hospitals and assist in auditing other coordinators to ensure correct processes have been followed.
• Communicate daily with Care Management Nurses to assist with eligibility and benefits.
• Checks eligibility and benefits when required.
• Process all ambulatory authorizations for designated hospital at the direction of the C.M. Nurse.
• Process ancillary discharge authorizations for members as needed and fax to appropriate vendor.
• Assist with auditing coordinators utilization of preferred ancillary providers.
• Assist in re-training for any utilization errors.
• Fax or E-mail hospital documentation (H&P and D/C summary) to PCPs for each patient.
• Daily review patient information on designated logs for accurate admit, discharge date, etc.
• Prepares appropriate denial letter at the direction of the C.M. Nurse.
• Maintains confidentiality of all patients and medical/clinical information.
• Monitoring incoming fax server and flag each fax with the standard color system to ensure proper routing of data; reporting any discrepancies to management.
• Attend management meetings to ensure full understanding of communication of these new processes to the team and assist supervisor with the new auditing tools.
• All other duties as directed by management.

Organizational Responsibilities :

• Proactively support and practice company mission, vision and values.
• Follow Employee Handbook guidelines and company policies and procedures.
• Follow established departmental dress code.
• Appropriately and accurately maintain time keeping records.
• Adhere to attendance policy and time off requests.
• Follow safety policies and procedures.
• Be flexible and adaptable and courteous and promote professionalism.
• Communicate verbally and in writing through appropriate channels.
• Maintain confidentiality at all times in compliance with company policy and HIPAA requirements.
• Employee has completed all required annual Compliance training and signed attestation form is attached for each module.

Compliance:

This position requires that the Employee abide by the Company’s Compliance Plan (including its Standards of Conduct) and all Compliance Policies and Procedures (as listed on the Company’s Intranets or Internet pages under Compliance).  This position further requires the Employee to act with the highest standards of integrity and professional ethics.   This would include but is not limited to the expectation and requirement that the Employee immediately report any potential Compliance, Security or Privacy, or potential Fraud-Waste-Abuse violations or issues to the Company’s Compliance Officer, Compliance Hotline, and/or to any Officer of the Company.

The pay range for this position at commencement of employment is expected to be between $26-$28/hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience. <