Care Coordinator Resume Samples

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F Rohan

Florine

Rohan

314 Shaniya Roads

Philadelphia

+1 (555) 664 2343

314 Shaniya Roads

Philadelphia

Phone

p +1 (555) 664 2343

Experience Experience

San Francisco, CA

Care Coordinator

San Francisco, CA

Mosciski-Watsica

San Francisco, CA

Care Coordinator

Performs outbound calls to providers to make appointment for patients or follow up on care
Provides disease management education and coaching to optimize Enrollee self-management and compliance
Participate in Interdisciplinary team meetings and Utilization Management rounds and provide information to assist with safe transitions of care
Provides clinical and medical management services, including case management, health assessments, interventions, and discharge planning
Directs providers/members to contracted provider network and facilities
Utilize both company and community - based resources to establish a safe and effective case management plan for members
Utilize both company and community-based resources to establish a safe and effective case management plan for members

Los Angeles, CA

RN Care Coordinator

Los Angeles, CA

Kihn-Rosenbaum

Los Angeles, CA

RN Care Coordinator

Conduct in person and WebEx meetings with practice managers, staff, providers and managers to communicate program goals and provide education
Perform other duties as they related to coordination of patient care as directed by the Manager of Care Coordination or the Director of Case Management
Collaboratively works with other associates, outside agencies and payors, providers, staff, and managers to coordinate and grow PCMH in SVPN clinic sites
Manage patients in current disease management programs, completing and revising as necessary, the information in care coordination documentation system
Evaluates patients overall risk using risk stratification tools and determines if meets routine case management or complex case management criteria
Works collaboratively with interdisciplinary team to develop goals and plan interventions to maximize patient outcomes
Works with practices on quality and process improvement initiatives

present

Houston, TX

Customer Care Coordinator

Houston, TX

Lemke Inc

present

Houston, TX

Customer Care Coordinator

present

Recognizes and develops relationships with provider groups through repeat calls, and recognizes provider sensitivities for different health plans
Ensure the customer provides proper data for project engineering to provide a quote
Provides recommendations for the continuous improvement of call center processes and service
Monitors the performance of the call center staff against key performance standards
May perform duties of an Administrative Assistant
Help to create and implement a Customer Care reporting system to bring visibility and awareness to trends and opportunities for improvement
Participates in SBU's Customer Care Operations activities as requested that help improve Care Center performance, excellence and culture

Education Education

Bachelor’s Degree in Nursing

The University of Kansas

Bachelor’s Degree in Nursing

Skills Skills

Strong nursing skills, excellent time management, strong team player, strong interpersonal and communication skills, flexibility and ability to multi-task
Ability to quickly achieve a working knowledge of Ateb’s Patient-Centric Solutions and Services
Ability to prepare quality data reports with attention to detail
Knowledge or ability to learn state and federal laws and regulations applicable to the call center is desired
Excellent clinical and assessment skills with the ability to work within an integrated healthcare team
Proven ability to meet quality and time standards
Strong organizational skills; able to prioritize tasks and meet deadlines
Basic knowledge of computer system, Microsoft Word, and Excel
Excellent attention to detail
Possess excellent communication and organizational skills with the ability to multi task, set priorities, and meet deadlines

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15 Care Coordinator resume templates

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Managed Care Coordinator Resume Examples & Samples

2+ years of Customer Services experience; 1+ year if experience working in a Healthcare setting
Solid analytical skills
Knowledge of Contracts, Enrollment, Billing & Claims Coding/Processing
Knowledge Managed Care principles
Ability to analyze and resolve problems with minimal supervision
Ability to use a personal computer and applicable software and systems

Wound Care Coordinator Resume Examples & Samples

3+ years of previous Hospital Nursing experience
Wound Care Certified (WCC) by the National Alliance of Wound Care and Ostomy
Previous experience in Wound Care within a hospital system
Microsoft Office/Suite proficient (Excel, Word, PowerPoint, etc.)
Certified Wound Care Nurse (CWCN) or Certified Wound Specialist (CWS)

Mortgage Customer Care Coordinator Resume Examples & Samples

Work with Site manager to determine staffing needs and allocate work based on overall sales volume and pipeline
Manage department to meet or exceed goals, objectives and standards in Service Level Agreements (SLAs)
Directly supervise openers/set-up clerk FTE to team goals that feed both departmental and organizational goals
Will provide overall process support to other Fulfillment areas based on business needs or business conditions
Insure team is verifying accuracy of documents received and properly preparing packages for submission to processing and underwriting
Oversee review of new submissions from loan officers according to quality control checklist and give appropriate feedback on deficient items to loan officers and Sales managers
Insure customer welcome packages are sent with pertinent loan documentation in a timely manner
Insures team is accurately identifying and categorizing loan documents for use by processing and underwriting
Retrieve, review, create, distribute and discuss reports related to the Department with staff
Monitor team quality accuracy and efficiency through coaching and mentoring efforts. Focus on quality control and review of loan files to ensure adherence to internal and external regulatory requirements
Must have three to five years residential mortgage Fulfillment experience
Must have at least two years of management experience
Broad understanding of residential mortgage loans
Detailed knowledge of processing, underwriting and closing procedures
Successful history of leading, developing, and mentoring staff
Excellent leadership, customer relations and interpersonal skills are required
Ability to motivate team, manage multiple projects, work under pressure, and adapt to sudden changes in the work environment
Strong planning and organization skills are required

Managed Care Coordinator Resume Examples & Samples

1+ year of Managed Care experience
Microsoft Office/Suite proficient (Outlook, etc.)
Knowledge of CPT/ICD codes

Care Coordinator Resume Examples & Samples

Function as a part of the comprehensive patient centered team
Use knowledge of Healthcare Effectiveness Data and Information Set (HEDIS) measures, quality reports and tools to evaluate patient needs for applicable labs and services. Order labs or preventative tests or schedule appointments as applicable
Assists patients in selecting appropriate goals to create a care plan, and monitor and update the care plans as needed
Prepare for and participate in regularly scheduled discussions of hospitalized patients
Participate in multi-discipline team conferences and mandated service training programs
Participate in the development and implementation of corrective action plans to address departmental and operational deficiencies
Demonstrate respect for the privacy and confidentiality of patient’s medical records and visits
Fluency in Spanish a plus
Licensed RN, LPN or LVN
Medical coding experience a plus

Rn-transition Care Coordinator Resume Examples & Samples

5+years of experience of in home case/care management experience with a bachelor’s degree in Human Services/Social Work or healthcare related degree/diploma, or 3years of experience in home case/care management with an active RN license with no restrictions in the state of Virginia
Prior nursing home diversion or long term care case management experience
Experience working with the geriatric population

Managed Care Coordinator Resume Examples & Samples

1+ years of Customer Service experience in a Call Center
Working knowledge of Medical terminology
Work experience with the elderly population

Pods Care Coordinator Resume Examples & Samples

Clinical background (RN)
Strong oral / written communication and presentation skills
Understanding of Humana’s clinical programs
Provider and member rewards program knowledge and experience

Humana Care Coordinator Resume Examples & Samples

Collaborate with other members of the Humana Cares interdisciplinary team to include; Humana Cares Manager-RN, Humana Cares Manager-Social Services, Field Care Manager and Community Health Educator
Bachelors degree in Behavioral Health or health related field
3 years of experience in care management, assessment, long term member/patient care management or community based resource delivery
Must have a separate room with a locked door that can be used as a home office to ensure you and your patients have absolute and continuous privacy while you work
Masters degree in Behavioral Health or health related field

Managed Care Coordinator Resume Examples & Samples

Requires ability to make sound decisions under the direction of Supervisor
Knowledge of Managed Care principles
Team player with strong analytical and interpersonal skills
Some college education
1-2 years customer service or medical support related position
Knowledge of contracts, enrollment, billing and claims coding/processing

Clincal Care Coordinator Northwest Arkansas Resume Examples & Samples

Provider education on referral management and processes
Monitor practice's patient participation in Humana's clinical programs
Facilitate member clinical program engagement
Identifies areas to engage member clinical program participation
Identify Chronic Complex members not participating in Humana Cares and refer PODS members to program
Expertise on Clinical Programs available to PODS members, and ability to analyze available data to identify members who can benefit from available programs
Consult with PODS owner on Clinical Program opportunities needing addressed in a Provider visit
Identify medication usage opportunities needing Pharmacy Consultant involvement
Ability to work with a team
CMS Stars/performance measures/HEDIS knowledge and experience

Managed Care Coordinator Resume Examples & Samples

Knowledge of Medical terminology
Adept with Microsoft Outlook
Flexible attitude
Knowledge of CPD and ICD codes

Care Coordinator Resume Examples & Samples

2-3 years of experience in healthcare field
License in Social Work
Demonstrated ability to make educated decisions at the point-of-care
Self-starter able to scope, manage, and deliver excellent care and results
Demonstrated ability to work effectively as a member of an interdisciplinary team, displaying good judgment and decision-making skills
Experience with computers, health information technology, and using mobile applications; demonstrated proficiency in spreadsheet creation and manipulation
Strong organizational skills; able to prioritize tasks and meet deadlines

Care Coordinator Resume Examples & Samples

Associate Degree RN
Minimum of three to five years' job-related experience
BSN or equivalent education and experience
CCM and/or ACMA certification or equivalent
Previous rehab experience

Managed Care Coordinator Resume Examples & Samples

1-2 years of customer service or medical support position
Some college completed
Knowledge of contracts, enrollment, and billing & claims coding/processing

Care Coordinator Care Manager Resume Examples & Samples

Conduct telephonic outreach to assigned members to assess health, environment, nutrition, and psycho-social areas of concerns using a variety of assessments
Excellent keyboard and web navigation skills
Demonstrated ability to proficiently use multiple programs to manage one process

Orthopedic Care Coordinator Resume Examples & Samples

3-5 years of recent clinical experience in ambulatory care, managed care, or acute medical-surgical
Strong interpersonal and collaborative communication skills
Working knowledge of Microsoft Office applications
Demonstrated proficiency in managing an EMR such as Epic or a Case/Care Management system
2+ years in health plan, home healthcare or ambulatory care setting management experience
Membership in Case/Care Management or related professional organization
Certification in Case Management, American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or Certified Professional Healthcare Quality (CPHQ)
MSN or Master's Degree in a healthcare-related field

Quality Home Care Coordinator Resume Examples & Samples

Experience coordinating home infusion cases and working with RNs/LPNs
1+ year data entry, word processing and/or medical records maintenance experience in a medical or healthcare customer service environment
Attention to detail, along with excellent organizational, verbal and written communication skills
Excellent computer skills

Transition / Care Coordinator Resume Examples & Samples

2 years of clinical experience preferably in an acute care, skilled or
Rehabilitation clinical setting
MUST LIVE WITHIN 20MILES OF MONTGOMERY COUNTY, VA
Prior Home Care experience
Prior Medicaid Waiver experience

RN Transition Care Coordinator Resume Examples & Samples

3years of experience in home case/care management with an active RN license with no restrictions in the state of Virginia
MUST LIVE WITHIN 20MILES OF ALEXANDRIA, VA
Education: BSN or Bachelor’s degree in a Human Services/Social Work or healthcare related field

Clinical Care Coordinator Resume Examples & Samples

Examine clinical programs information to identify members for specific Case Management/Chronic Care / or Disease Management activities or interventions by utilizing established screening criteria
Consult with Clinical Program Case Mangers and nurses to identify member specific opportunities to address with a Provider
Review member specific and provider specific data to identify concerns needing follow up by assigned Case Managers
Coordination of Clinical Program specific representation or input in to PODS Owner or Strategy Meetings

Transition Care Coordinator Resume Examples & Samples

5+years of experience of in home case/care management experience with a bachelor’s degree in Human Services/Social Work or healthcare related degree/diploma, or- 3years of experience in home case/care management with an active RN license with no restrictions in the state of Virginia
Bachelor’s degree in Social Work in the state of Virginia (with no restrictions and the ability to be licensed in multiple states
Prior experience with Medicaid or Medicare recipients

Msw-transition Care Coordinator Resume Examples & Samples

MSW and RN’s must have 3 years of experience in home case/care management. RN must be licensed with no restrictions in the state of Virginia
MSW licensed in the state of Virginia
Certified Case Management Certification

Managed Care Coordinator Resume Examples & Samples

2+ years of Credentialing / Payor Enrollment in a Healthcare provider or Insurer environment
Bachelor's Degree in Business Administration or related field from an accredited college or university
Knowledge of Credentialing software and cloud based practice management software

Managed Care Coordinator Resume Examples & Samples

1-2 years of experience in a customer service or medical support related position
Ability to make sound decisions under the direction of Supervisor
Strong Analytical and Interpersonal Skills
Some college experience

Managed Care Coordinator Resume Examples & Samples

1+ year of relevant experience
1+ year of experience in a Customer Service or Medical Support related position
Knowledge of Contracts, Enrollment, Billing & Claims Coding / Processing

Care Coordinator Resume Examples & Samples

2 years of Managed Care / Case Management experience
Knowledge of Utilization Review (Article 49)
Exceptional communication skills
Compassionate and empathetic $
Knowledge of HIV and HIV Care

Msw-transitions Care Coordinator Resume Examples & Samples

RN’S or MSW’S must have 3 years of experience in field home case/care management. RN must be licensed with no restrictions in the state of Virginia
Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance from Humana systems if 5Mx1M
MUST LIVE WITHIN 10-20 MILES FROM HENRICO, VA

Customer Care Coordinator Resume Examples & Samples

Identify our customers' needs or customers' segments and define the related strategy
Define in accordance with the Business Unit and Supply Chain Director and the Customer Care policy and priorities
Implement the organization, processes, and resources needed for the Customer Care policy
Ensure the smooth execution of the order-to-cash cycle in full conformity with the Supply Chain Management Standards of the Group (cut off, tariff, sales terms and conditions)
Develop the collaboration of the credit policy defined with the Financial and Controlling Director
Develop the collaboration with our clients (data exchanges, shared KPIs, flows optimization, cost follow p, OSA, stock in trade, B to B portal, etc)
Ensure the sharing and reliability of information related to the clients within the organization (Demand Planning, physical distribution, sales, controlling)
Recruit, develop and manage his/her team taking care of the know-how transfer and the development of expertise -- implement organizational changes
For the "field" expert ("Local Business Owner"): Contribute to the improvement of the processes and information systems related to his/her activity and be the referent of his/her job in his/her country. Animate and train the Supply Chain community to the best practices and tools related to his/her area of expertise
Turnover for the L'Oreal business (all brands) weekly meetings with brands/DM and team to assess monthly turnover
Animate and train the Supply Chain community to the best practices and tools related to his/her area of expertise

Nonclinical Care Coordinator Resume Examples & Samples

3-5 years of previous experience working within an Emergency Department
NYS Nurse Practitioner (NP) and/or Physician Assistant (PA) license
Comfortable with Pediatrics dosing of common antibiotics
Previous experience with EMR and Scribes

Candidate Care Coordinator Resume Examples & Samples

Provides guidance on methods, policies and procedures, and serves as subject matter expert on more complicated recruiting topics
Participates in, or may lead, special projects such as analysis, reporting, communications, security access, and training
Maintains applicant tracking system by posting, monitoring, and closing job requisitions, and updating candidate statuses throughout the selection process. Reviews documents, including requisitions, to ensure compliance with EEO and Company policies
Supports Recruiters in sourcing and screening candidates using internal posting systems, external postings, the internet, print advertisements, outreach efforts, employee referrals, etc
Assists in the scheduling and preparation of candidate interviews and testing by sending confirmations or itineraries, coordinating travel arrangements (when necessary,) managing interview day logistics (e.g. security,) and providing timely follow up
Assists in the coordination of Open Houses and Group Information Sessions
Supports on-boarding process for new hires and transfers including processing new hire paperwork and assisting with the coordination of orientation and training
Prepares reports and presentations outlining recruitment efforts
Manages vendor invoices. Manages cases in background vendor websites ensuring cases are closed in a timely manner
Under supervision, manages projects in the talent acquisition arena ranging from employment branding to innovative sourcing techniques to candidate experience feedback surveys
Updates operational/business leadership on progress, gaps, and potential failure factors that are encountered in day-to-day interactions with vendor or vendor staff
Oversees testing where appropriate

Managed Care Coordinator Resume Examples & Samples

1-2 years of customer service or medical support experience
Knowledge of ICD 10 codes
Previous work experience in doctor's office or with a health insurance background
Some College experience
Ability to use a personal computer

Customer Care Coordinator Resume Examples & Samples

Answering customer phone and email enquiries relating to delivery due dates, invoices, credit requests, etc
Support the Sales Representatives in all Australian States
Process credit requests in the SAP system and organise stock returns with the courier company
Coordinate the returns of deleted cosmetics lines from stores
Process store opening orders

Pipc-care Coordinator RN Resume Examples & Samples

Active South Carolina RN License
Recent hospital patient care experience; cardiac or med-surg preferred or recent SNF, hospice, LTA, Rehab
Excellent communication, customer service and telephone skills
Strong desire/interest to provide telephonic patient care
4 to 6 years of clinical experience with in a hospital, SNF, hospice, LTAC, Rehab preferred
E-ClinicalWorks (e-CW)

Care Coordinator Resume Examples & Samples

Elicits values and incorporates family's culture in developing individualized service coordination planning
Develops with the Child & Family Team a coordinated, proactive crisis/safety plan that addresses immediate and ongoing needs
Provides documentation of Child & Family Team meetings to team members and others as needed to support communication, inclusion and accountability
Coordinates and manages the scheduling of Child & Family Team meetings
Assists the youth and family in accessing strengths-based mental health, social services, educational services and other support and resources required to assist the family to attain its vision
Manages a diverse caseload of up to ten (10) clients and ensure that frequency of meetings is responsive to the need for planning
Has the ability to work independently, and to meet with families at their available times which may require early morning, evening and/or weekend hours

Managed Care Coordinator Resume Examples & Samples

Demonstrated interpersonal skills
Team-oriented
1-2 years of experience in a customer service or medical support-related position

Managed Care Coordinator Resume Examples & Samples

Previous work experience in a doctor's office or with health insurance company
Exceptional written and verbal communication skills
Exceptional decision-making skills

Ambulatory Care Coordinator Resume Examples & Samples

Bachelor's Degree in Social Work or Psychiatric-related field
Psychiatric Care experience
Understanding of Mental Health Benefits with Insurers, Medicaid, Medicare, etc

Care Coordinator Resume Examples & Samples

1+ year of Medical-Surgical experience
Working knowledge of Microsoft Office
Prior home care experience
Relevant CHHA experience
Bilingual in English and Spanish, Russian, or Mandarin

Quality Care Coordinator Resume Examples & Samples

Examine and analyze clinical program data to identify members for specific Case Management/Chronic Care/ or Disease Management activities or interventions by utilizing established screening criteria
Collaborate with Provider Engagement Consultants, Provider Engagement Executives, Clinical Consultants and others internally as appropriate to conduct provider education on referral management, processes, and tracking
Frequently monitor member participation in Humana's clinical programs; data entry as required for alternate contact information received from the provider groups
Promotion of Humana's clinical programs and resources
Assist with facilitation of member clinical program engagement as appropriate
Consult internally to identify member specific opportunities to be addressed at Provider visit
Specifically identify Chronic Complex members not participating in Humana Cares Chronic Complex program and make referrals as indicated
Provide expertise on Humana’s Clinical Programs and act as a liaison between the Provider Engagement Team and internal care management teams
Provide analysis, trending, and summary reporting internally on utilization and care management performance throughout the market
Identify Part D opportunities at the member level that may warrant Pharmacy Consultant collaboration
Conduct member outreach as needed/appropriate for various clinical initiatives
Represent the Provider Engagement Team during internal care management and utilization discussions
Active RN licensure
Prior clinical experience preferably in a fast paced insurance or health care setting
Experience thriving in a matrix environment
Excellent PC skills (including MS Word, Power Point, Excel)
Education: Bachelor’s degree in Nursing
Previous Health Plan experience
CMS Stars/HEDIS knowledge and experience
Utilization and/or case management knowledge and experience
Familiarity with Population Health Management and Value Based Provider Agreements

Care Coordinator RN Resume Examples & Samples

1 year of experience working in the mental health field
Excellent assessment and critical thinking skills
Exceptional time management, prioritization, multi-tasking and organizational skills
Strong documentation and phone triage skills
Team oriented and adaptable to changing environments and is capable of effectively managing pressure and stress

Care Coordinator Resume Examples & Samples

Minnesota RN Licensure
Proven experience with an EMR system
Exceptional communication and customer service skills

Care Coordinator Resume Examples & Samples

Examine clinical programs information to identify members for specific Case Management/Chronic
Promote Humana's clinical programs and resources
Identifies member quality/Hedis gaps and support gap closure by facilitating
Clinical background - LPN license required
Strong analytical skills, able to manipulate and interpret data
Case Management Experience
Experience in a state and/or federally regulated health care environment

Care Coordinator Resume Examples & Samples

Active Registered Nurse license or Licensed Practical Nurse certification, with the addition of an equivalent combination clinical and managed care experience
2 years' health care or managed care experience
2 years' HIV/AIDS, medical or chronic care experience
Demonstrated knowledge of Article 49- Utilization Review process
Strong knowledge of Microsoft Office (Access, Word and Excel)
Demonstrated understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts
Demonstrated appropriate behaviors in accordance with the organization's vision, mission, and values

Customer Care Coordinator Resume Examples & Samples

Handle incoming phone calls in a customer support environment
Provide answers to customer inquiries, i.e., order status, expected ship date, proof-of-delivery, part number, pricing, shipping information, customer account information, etc
Open depot repair requests
Record customer feedback and complaint information
Process customer feedback regarding products and services as required
Work with customer to understand needs and offer other/additional products to optimize OSA sales
Perform all tasks in a call coaching and recorded environment
Flexible work schedule within business hours of operation which is currently Monday – Friday, 7 a.m. to 5 p.m. CST with overtime as required
Must be reliable and accountable regarding shift start time
Meet or exceed the goals established based on the call center measurements
Associates Degree preferred, or equivalent training and work experience
Three years experience in a customer service environment
Strong computer system knowledge and working ability including the following applications: Outlook, Word, Excel, Windows, Siebel, Oracle
Building Relationships: Initiates contact with other individuals; builds and maintains positive relationships to accomplish organizational goals; relates to people in an open, friendly, accepting manner; shows sincere interest in others and their concerns
Communication Skills: Strong and effective verbal and written communicator and presenter - one on one and in-group settings
Initiative: Takes charge to make things happen; identifies what needs to be done and does it
Listening: Actively hears others, ensuring a complete and accurate transfer of information
Problem Solving: Identifies root causes of problems; generates and evaluates alternative solutions; implements problem resolutions quickly and effectively; fact-based decisions
Persistence/Resilience: Works at responsibilities until they are successfully completed; tries alternative approaches when confronted with obstacles or criticism; works diligently to achieve difficult objectives
Multi-tasking: Ability to prioritize and meet deadlines. Adaptable to multiple requests and daily changes

RN Care Coordinator Cardiology Resume Examples & Samples

Patient education and pro-active disease management experience
Excellent assessment and care coordination skills
Experience with an EMR

Care Coordinator Resume Examples & Samples

Performs outbound calls to patients to understand their clinical needs and connect them with appropriate resources
Performs outbound calls to providers to make appointment for patients or follow up on care
Answers inbound calls from patients, providers, and Village resources, as necessary
Follows up with patients to ensure their needs are met and schedules future check ins
Coordinates with clinical resources and providers to ensure smooth continuum of care for patients
Monitors patient hospitalizations and follows up as necessary with a VillageHealth Nurse (VHN)
Notifies patients of location and appointment times as needed
Provides patients with education materials and sends letters to primary care physicians, nephrologists, and specialists for new enrollments/appointments
Assists with the referral process
At least two (2) years of experience in a professional office environment
Intermediate proficiency in MS Word, Excel, PowerPoint, and Outlook
Deals with confidential information and/or issues using discretion and judgment

RN Care Coordinator Resume Examples & Samples

Presents alternatives to inpatient stay to attending MD, team and patient / family based on assessed patient level of care and insurance benefits
Seeks assistance and/or consultation from Care Coordination leadership with plans for outlier and potential or actual resource intensive patients
Interacts with internal and external health care providers to facilitate patient care including post discharge services
Contributes to the development, implementation and monitoring of practice guidelines
Identifies attending, resident and nurse learning needs related to case management and works with service leaders to develop educational plan
Initiates contact with home health agenciesand extended care facilities to insure prompt and effective transition of care
Conducts documented utilization reviews to insurers or intermediaries
Identifies SNF and AND days for Medicare and Medicaid patients
Initiates actions concurrently to reduce and/or eliminate inappropriate hospital admissions and days, and system delays
Works with payers and physicians to concurrently address level of care concerns effecting claims and reimbursement
Contributes to utilization and practice improvement efforts by reviewing reports with colleagues and providing feedback on utilization trends and payer issues
Serves as the primary patient information source to third party payers
R.N. required, MA license, BSN preferred
Knowledge and skills to differentiate levels of care required
Five years of previous acute care experience in related clinical specialty preferred
Two or more years experience with hospital utilization review and medical criteria sets preferred
Five years of experience with discharge planning, knowledge of community resources and patient education principles preferred as a case manager
Certification in case management preferred
Previous experience in a hospital or health care setting
Bilingual (English/Spanish) preferred
Strong clinical assessment skills
Excellent interpersonal skills including ability to work collaboratively and cooperatively within a team and with internal and external customers
Strong organizational skill and ability to set priorities
Ability to compile data from concurrent and retrospective medical record review to determine clinical appropriateness, able to demonstrate the ability to meet a patient’s needs based on their clinical diagnosis, level of care and discharge plan
Ability to negotiate several aspects of care coordination simultaneously

Care Coordinator Resume Examples & Samples

Defines and ensures compliance with disease-specific care paths for specialty care or chronic disease
Works with the patient and family to assess current knowledge, health literacy, and readiness to change, utilizing teach back to assess level of knowledge
Will function in the specialty care coordinator role. Experience in palliative medicine is preferred
Experience working in an inpatient office or outpatient clinic is highly desired

UM Care Coordinator Resume Examples & Samples

Serves as a liaison in corresponding and communicating with providers, vendors and WellCare contacts and/or members representative’s
Preferred An Associate's Degree in a related field
Intermediate Other Work effectively within group to achieve desired outcomes
Required Intermediate Microsoft Outlook Proficient in Microsoft Office such as Outlook, Word and Excel

Care Coordinator Resume Examples & Samples

Provides technical and administrative support to clinical and behavioral staff as needed
Produces, formats and edits correspondence and documents
Participates and supports nursing tasks, including but not limited to: faxes, discharge preparations, request of clinical information, and creation of authorizations if necessary
Required A High School or GED
Required 3+ years of experience in a managed care setting, medical office or facility setting with demonstration of medical administration duties
Required Intermediate Microsoft Excel

Care Coordinator Spine Resume Examples & Samples

Outlines the nature and duration of involvement needed by the specialty care team and specialty care coordinator then identifies the primary care team involved
Performs reassessments regarding patient progress toward goals and updates plan of care as appropriate
Serves as the liaison between patients, families and physicians, clinical staff by advocating for patient and families then responding to and facilitates resolution of patient/family questions and concerns

Care Coordinator Resume Examples & Samples

3+ years experience in an managed care setting, medical office or facility setting with demonstration of medical administration duties
Knowledge of medical terminology, CPT-4 and ICD-9 coding
Ability to effectively communicate and present information
Work effectively within group to achieve desired outcomes
Solid verbal and written communication skills
Proficient in Microsoft Office such as Outlook, Word and Excel

Clinical Care Coordinator Resume Examples & Samples

Works closely with hospitals, clinics, health care facilities, MD practices and agency clinical and administrative personnel to ensure referrals for patient care needs are sent to Home Health agency as seamless, efficient, effective, appropriate and complete information as possible at the time of the referral. Requesting additional information as needed
Interacts daily with referral sources, medical professionals , Account executives and the home health agencies to achieve continuity of care, coordination of medical care needs of patients by determining all ordered disciplines, equipment and care needs are addressed as recognized on referral info and sent to appropriate CHS agencies or outside agencies as deemed necessary
Evaluates the appropriateness of the patient's admission to home care from referral information and provides education of Home health requirements to referral sources as needed
Receives referrals and orders from physicians, hospitals and other agencies and acts as a resource for clinical team members
Establishes lines of communication among appropriate agency personnel and personnel of area health facilities to assure a flow of information and provide a continuum of care
Maintains referral list and follows up as needed until patient is sent to be data entered or determined not appropriate for Home health
Responsible for quality assurance on patients in workflow in order for workflow to get to branch for scheduling of patient

Care Coordinator Resume Examples & Samples

Engage members telephonically to coordinate services, community resources, and treatment needs
Deliver a holistic approach to coordinated care based on the enrollee needs
Identify early risk factors, conduct ongoing assessments and document in an electronic file
Create, review and revise Plan of Care plans and focus on disease management
Function as an advocate for members and decrease unnecessary hospitalizations
Collaborate with the member's PCP to deliver and coordinate necessary services
Build relationships with members and their families; assist them with proper health choices
Ensure cases are documented in a timely manner
2+ years clinical or case management experience
1+ years experience in long-term care, home health, hospice, public health, or assisted living
Basic level of proficiency with Microsoft applications such as (Word, Excel, Internet, Outlook)
Bachelor's level degree in Social Work
Current unrestricted RN or LPN license
Background working in geriatric special needs
Background in behavioral health

Field Care Coordinator Resume Examples & Samples

Collaborate with patient, family, and healthcare providers to develop an individualized plan of care
Licensed Social Worker (LBSW, LMSW, LCSW)
1 year of experience in hospital, long-term care, home health, hospice, public health or assisted living

Field Care Coordinator Resume Examples & Samples

Independent Licensed Master's degree as a mental health professional in Idaho (Social Work, LMFT, LCPC, LP, RN). Licenses must be active and unrestricted
2 + years experience in a related mental health environment
Proficient computer skills and good working knowledge of Microsoft Word, Outlook, and Internet

Field Care Coordinator Resume Examples & Samples

Master's level degree in Social Work
Access to reliable transportation to be able to conduct field visits
1+ years of clinical or case management experience
1+ years of experience in long-term care, home health, hospice, public health, or assisted living
Basic level of proficiency with MS Office and database documentation (Word, Internet, Outlook)
701 B certification

Point of Care Coordinator Resume Examples & Samples

Ability to read, analyze, and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals
Ability to compute rate, rate ratio, and percent and to draw and interpret bar graphs
Ability to perform basic statistical functions
Ability to work with laboratory information system
Knowledge of Microsoft applications such as Word and EXCEL

Care Coordinator Resume Examples & Samples

Maintain daily tracking tools to support data reporting, including but not limited to the following list
BSN preferred, InterQual experience preferred
Case Management Certification preferred (ie. CCM, BC, ACM)
Demonstrated data analytic skills
Knowledge and proficiency with Microsoft Word, Excel and PowerPoint required
Demonstrated skills in working collaboratively with physicians, managers and other team members
10+ years experience and has worked in multiple case manager settings successfully

RN Care Coordinator Resume Examples & Samples

The RN Care Coordinator will be assigned to selected areas of the Hospital on a rotating basis to perform utilization reviews and other UM activities, as needed based upon department staffing and coverage
Will support and coordinate the activities of the Social Workers assigned to the unit
As this is an evolving position, duties and responsibilities may vary based on specific assignments
Masters Degree preferred
Current licensure in Massachusetts as a Registered Nurse required
Recent experience in acute care setting involved with clinical activities and/or a managed care environment working in case management
Recent experience in case management role or related role
Excelled computer skills including managing work against performance metrics and reporting on key indicators important to the department
Knowledge and proficiency with Microsoft Word, Excel, and Power Point
Strong data analytic skills to prepare and monitor management reports regarding the performance of the area assigned and the department
Demonstrated experience with managing against clinical and financial indicators and performance goals
Demonstrated skills in working collaboratively with physicians, managers, and other team members
Demonstrated skills in organizing and directing staff teams to complete assignments accurately and on time
Exempt position
Evidence of continued professional development

Transition Care Coordinator Resume Examples & Samples

1. Performs onsite assessment and review of admitted Members to assure that appropriate discharge plans are in place to allow Member's care to continue in the appropriate alternate setting: Home, Home with Home Health, SNF, etc
2. Explores and coordinates appropriate alternatives to acute care and communicates recommendations to attending physician, Members/authorized representatives, facility staff and The Organization Medical Director to facilitate appropriate and timely action
3. Actively interacts with hospital, SNF, NH staff as well as Members and/or Authorized Representatives throughout the discharge planning process to explain benefits, assist with discharge planning, notify of denial of coverage with explanation of appeals rights and explore appropriate alternative options
4. Identifies and communicates potential discharge delays and available discharge options to the attending physician, and works in collaboration with the attending physician, facility discharge planning staff, outpatient resources, Member, family, Primary Care Physician and other appropriate parties to develop and implement the optimal plan of care
5. Utilizes knowledge of community resources and alternate funding arrangements available to Members when services are not covered under the Members benefit program. Educates member/member's family regarding alternative assistance including contact information
6. Involves appropriate staff in discharge planning to assure coordination of follow-up after discharge
7. Develops relationships with facility social workers and community resources as well as to assure maximizing the effective management of catastrophic and chronic cases
8. Identifies and reports appropriately all situations which might expose the organization to legal liability and/or which are indicative of potential quality of care issues
9. Maintains the confidentiality of all Member information in a manner consistent with HIPAA standards
10. Actively involves with Beacon Health LLC Regional Director of Care Coordination and the Medical Director to maximize management opportunities in specific cases
11. Participates in the development or revision of programs to reduce re-admissions for Members with acute and chronic conditions and assists with decreasing inpatient length of stays
12. Identifies opportunities for change in processes and assists MM leadership with implementation of same
13. Identifies reporting opportunities and assists in the implementation and/or upgrade of reporting
14. Streamlines workflow processes and coordinates with all segments of Beacon Health LLC Services to assure coordinated care without redundancy
15. Actively manages requests for admissions to acute inpatient rehabilitation, Long Term Acute Care (LTAC) facilities and Skilled Nursing Facilities. Includes completion of pre-certification and notification to Member/Provider within regulatory time frames
Performs related and unrelated duties as assigned
Denotes essential job functions

Field Care Coordinator Resume Examples & Samples

Independent Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, or Licensed Ph.D., or an RN with 2 or more years of experience in behavioral health
License must be independent, active, and unrestricted
Access to high speed internet services
Dedicated space for home office set up

Care Coordinator Resume Examples & Samples

Utilize both company and community - based resources to establish a safe and effective case management plan for members
Identify and initiate referrals for social service programs; including financial, psychosocial, community, and state supportive services
Current, unrestricted RN License or Social Work License (LBSW, LMSW, LCSW) for the State of TN
1+ year of experience in long - term care, home health, hospice, public health or assisted living
Reliable transportation to be able to conduct field visits
Basic computer proficiency, must be able to type and navigate a Windows based environment
Medicare or Medicaid experience

Clinical Care Coordinator Resume Examples & Samples

Computer literate & proficiency in Microsoft applications: excel, word, outlook
Ability to use Electronic Medical Records
Bi-Lingual in English/Spanish a plus
2 or more years of experience in a healthcare setting (hospital or clinic)
Degree from a two year college preferred

Managed Care Coordinator Resume Examples & Samples

Financial analysis and advanced knowledge of Excel
Familiarity with Physician/Payer contract language
Good communication and organization skills
Business office operations

Long Term Care Coordinator Resume Examples & Samples

Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors. Researches and resolves any electronic claim denials
Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods
Processes any necessary insurance/patient correspondence
Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians
Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process
Provides training and support to inter-departmental associates
Independently and effectively resolves advanced accounts with minimal supervision
May travel to sites to present program services and further build relationship with sites
Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation
Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims
May have responsibility for particular geographic regions, physician office sites
Works on problems of diverse scope where analysis of data requires evaluation of identifiable factors. Demonstrates good judgment in selecting methods and techniques for obtaining solutions. Networks with internal and external personnel in own area of expertise
Strong negotiating skills
Strong organizational skills; attention to detail
Proficient knowledge of accounting principles, pharmacy operations, and medical claims
Proficient knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding
Ability to proficiently use Microsoft Excel, Outlook and Word
A seasoned, experienced professional with a full understanding of area of specialization; resolves a wide range of issues in creative ways. This job is fully qualified career-oriented position

RN Care Coordinator Resume Examples & Samples

License and current registration to practice as a registered professional nurse in New York State required
At least 2 years RN experience required
Experience in managed care, hospital case management, or home care required
Clinical expertise in geriatric care preferred
Able to use a computer

Transition Care Coordinator Resume Examples & Samples

Serves as a support and resource to Case Managers in the evaluation of enrollees for eligibility for transition
TC will make face to face visits with members in nursing homes in established territory to assess for feasibility to transition and/or to manage transition planning as needed
TC will complete weekly follow-up calls for 30 days post transition to assure safety and satisfaction with the new environment/home
Completes necessary transition/repatriation assessments
Engages with nursing home staff such as Social Workers, Administrators, Therapists, Physicians, and Directors of Nursing in transition planning for best outcomes
Communicate effectively with the enrollee and their families/responsible parties throughout transition process. Must be a resource to all parties involved
For members who are newly custodial (60-days), the TC will complete a telephonic or coordinate a face-to-face visit with the member to assess for possible repatriation to HCBS setting
Collaborates with and updates the assigned case manager throughout transition process
Responsible for accurate reporting of all transitions to appropriate Manager of Case Managers and to Manager of Transition Team
Diligently work on building and establishing trusting collaborative relationships with nursing home and assisted living facility staff
Bachelor’s degree or higher in Social Work
2 years of experience in long-term care, home health, hospice, public health or assisted living
Licensed Social Worker (LCSW, LMSW)
CCM certified
Hospital/SNF discharge planning experience

RN Care Coordinator Resume Examples & Samples

3-5 years in recent active RN clinical practice, preferably caring for patients with complex or chronic conditions
Strong preference for experience in practice situation requiring significant independent decision-making and action, such as community, home health or office practice nursing
Prefer experience in managed care, population health, case management or chronic disease management environment
License/certifications
Current Colorado RN license in good standing
Prefer certification by relevant professional organizations such as CMSA, AAAPC and others

Field Care Coordinator Resume Examples & Samples

3+ years of behavioral health experience and / or work in a healthcare environment
Proficient computer skills including the ability to type and talk at the same time and toggle between multiple screens
Ability / willingness to travel daily within the service delivery area (Bradenton, FL / Manatee County, FL)
Active and unrestricted behavioral health license in the state of FL (i.e. LCSW, LMFT, LPC, LMSW)
Case management / care coordination experience in a clinical setting (hospital, long term care)
Experience with medical social work
Bilingual skills (fluency in Spanish)

Care Coordinator Resume Examples & Samples

Provides care and disease management to high risk patients identified in the ambulatory setting
Identifies which patients in the specialty practice have ongoing care coordination needs for their specialty condition
Outlines the nature and duration of involvement needed by the specialty care team and specialty care coordinator
Identifies the primary care team involved in the specialty patient care
Conducts comprehensive clinical assessments that include disease-specific, age-specific, medical, behavioral, pharmacy, social and end of life needs of each patient. Involves the patient and family regarding coordination of their care. Shares this information with the healthcare team, patient, and family
Serves as primary patient contact for team related to condition; facilitates access to services
Serves as the liaison with patients and families to physicians, clinical staff
Assists in managing transitions of care across care settings, ensuring optimal communication and planning between care providers across different settings
Connects patient back to primary care physician and primary care coordinator team as applicable
Liaison with other partner care coordinator teams across settings (e.g. transitional care). Partners with other care coordinator teams (e.g. primary and transitional care)
Coaches patient and family on self management support including setting long and short term goals (including acute exacerbation management)
Utilizes education about managing a specialty condition, including prevention and health maintenance tasks. Provides education to other care providers and community resources to enhance care
Assists in education, auditing quality, data analysis, and workflow processes with the outcome metrics such as patient satisfaction, readmissions, cost per case, and compliance with care paths or evidence based guidelines

Care Coordinator Resume Examples & Samples

Assessment of members to identify unmet needs, coordinate services, community resources, and treatment needs
Minimum of 2 year clinical or case management experience
Minimum of 1 year experience in long-term care, home health, hospice, public health, assisted living, and or working with the elderly and physically disabled

Clinical Care Coordinator Resume Examples & Samples

Registered Nurse in the state of North Carolina
3 years of health insurance experience in Claims and/or Customer Service
Provide clinical consultation with non-clinical staff within the Appeals Department
Coordinate all aspects of the appeals process to ensure compliance with medical necessity criteria, Corporate Medical Policy (CMP), contract provisions, NCDOI, legislative, federal and NCQA requirements, as applicable
Assist with Level 3 appeals as required
Analyze complex/non-routine member and provider appeals and grievances for all lines of business, excluding FEP, by reviewing CMP, contract provisions, legislation and/or NCQA requirements
Identify appropriate documentation collection from multiple external sources such as pharmaceutical companies, attorneys, providers, etc
Present analysis and documentation to appropriate physician committee, benefit administrators and Client leadership, as necessary
Initiate claim adjustments on individual cases when necessary
Provide written documentation of case determinations to appellants and/or all involved parties in a timely manner as required by mandates and legislation
Identify trends and high-risk issues to make recommendations to address future exposure
Identify and take corrective action on appeals that result from noncompliance of contract provisions, appeal guidelines and/or CMP
Create action plans to educate internal employees of benefit misinterpretation and/or claim system errors
Answer member/provider questions via incoming telephone calls in a professional quality driven manner
May handle complaints/grievances as defined by the federal government
Coordinates with external vendors and provides requested information as requested

Customer Care Coordinator Resume Examples & Samples

Answer incoming customer calls and register the details of the call into a service management system
Quickly determine how to respond to a customer call, taking into consideration the customer’s request and contractual agreements
Assign and dispatch Field Services Engineers (FSE’s) based on the advice from an onsite helpdesk taking into consideration the FSE's location, workload and urgency of the situation
Order spare parts if required and inform FSE on when these will be delivered
Ensure customers are aware of the status of their call and the actions taking place. For regular maintenance you will be required to make detailed appointments
Manage the progress of the customer call until resolved, communicating with various colleagues, you may need to escalate the situation if service levels may not be met

Field Care Coordinator Resume Examples & Samples

Expected to travel to Pasco and Pinellas counties and feel comfortable with a caseload of 70-80 members*
Basic to intermediate computer skills in Outlook, Microsoft Word and Excel
Ability to speak Spanish

Point of Care Coordinator Resume Examples & Samples

Standardizes practices, policies and procedures (SOP’s) across POC testing locations. Ensures policies, procedures and associated forms reflect current practice. Creates and revises policies, procedures and forms. In collaboration with POC Managers ensures the annual review and sign off of policies and procedures by the CLIA Laboratory Director. Assists with the maintenance of the Clinical Laboratory POCT Manual
Provides training thru collaboration with POCT location managers and nurse educators to educate and orient all testing personnel performing POC testing. Assists with Healthstream training module design, implementation and revisions and other training documentation. . Provides ongoing education on Joint Commission/CLIA requirements, quality control and good laboratory practices. Ensures completed documentation is complete, reviewed and maintained
Collaborates with POCT location managers, nurse educators and other personnel to ensure ongoing competency of all staff performing POC testing. Assists with creating annual schedules and competency assessment tools. Ensures competency requirements by Joint Commission, CLIA or other regulatory agencies are met and associated documentation is completed for each employee on an annual basis. Ensures failed competencies are addressed appropriately and is timely. This includes competency assessment for providers performing Provider Performed Microscopy (PPM) testing. Ensures documentation is complete, reviewed, compiled and maintained
Ensures the regulated and non-regulated Proficiency Testing (PT) programs for POC testing staff is managed appropriately for each area; annual renewals completed, testing rotated amongst staff, compliance with testing schedules and oversight of corrective actions. Oversees the biannual accuracy and reliability assessment for Provider Performed Microscopy (PPM) testing. Compiles and maintains all documentation
Performs POCT instrument evaluation and makes recommendations for new equipment. Validates new instruments, troubleshoots and revamps out of service instruments. Validates instrument interfaces. Performs instrument cartridge and reagent validation prior to use. Sequesters new lots. Compiles and maintains all documentation
Performs instrument linearity, calibration verification and biannual method comparisons. Schedules offsite and POCT method comparisons; ensures compliance with testing performance schedules. Compiles and maintains all documentation
Ensures daily, weekly and monthly maintenance is performed and documented . Ensures POC instrument preventative maintenance is performed on schedule and documented. Assists with the maintenance of vendor contracts; annual review and renewals
Reviews daily, weekly and monthly quality control records for completeness and accuracy; documents noncompliance, implements corrective action plans in collaboration with POC area managers. Maintains a working knowledge of manufacturers’ quality control recommendations and guidelines. Assists with quality control as needed and monitors quality control trends
Reviews temperature and maintenance logs. Documents review
Collaborates with POC area managers to ensure ongoing Joint Commission survey readiness. Using audit tools and checklists organizes and performs tracer audits against Joint Commission and CLIA standards at a minimum of twice (2x) per year. Evaluates, summarizes and reports findings to POC and Clinical Laboratory leadership. Assists POC area managers with addressing findings. Audits patient results in medical record
Assists with the evaluation and implementation of information system solutions for POC instrument interfaces; results, quality control, capturing required instrument data
Assists with other Clinical Laboratory Quality Assurance and Regulatory Compliance initiatives to include coverage for other Clinical Laboratory POC Coordinator responsibilities, team projects, data collections, etc
Maintains effective working relationships and works collaboratively with POC and Clinical Laboratory leadership, coworkers, nurse educators and POC testing personnel. Exercises effective communication skills with all departments
Complies with all hospital safety requirements. Is knowledgeable about hospital policies concerning fire drills, OSHA regulations, hazardous waste management and chemical hygiene
Performs all other duties as required
Must have demonstrated full competency and highly effective performance as a medical technologist
Must possess a Bachelor’s Degree in medical technology, or chemical, physical, or biological science from an accredited college or university or other qualifications as described in the Federal Register, 42 CFR, Subpart M 493. 1403-1495
Three (3) years of Clinical Laboratory experience preferred
MT (ASCP), CLS(NCA) or equivalent certification preferred
Must have good interpersonal, communication, management, and administrative skills

Managed Care Coordinator Resume Examples & Samples

Minimum of two years medical terminology and coding experience
Two or more years direct experience in claims administration in an insurance company or Managed Care area
Minimum of two years experience with automated authorizations and/or claims processing systems
Three years or more experience in HMO Claims processing
Competency in MS Office and other Managed Care programs
Accuracy to work and attention to detail
Ability to identify, understand and solve problems related to claims and referral
Proven ability to quickly adjust to changing projects and priorities and ability to multi-task

Customer Care Coordinator Resume Examples & Samples

Record, take ownership and resolve Customer complaints in line with company KPI’s. Where necessary co-ordinate activities with other departments to ultimately ensure complete Customer satisfaction
Build relationships with key customers and utilize that relationship to manage requests from the customer for mutual benefit
To handle all incoming telephone calls dealing with Customers’ needs and expectations in line with procedures, and according to departmental KPIs
Attend relevant meetings to identify ways we can improve the service we offer to both internal and external Customers and to communicate Customer Service KPIs and strategy
Assist with other areas of the business as required, providing backup support for team member where necessary
3 to 5 years relevant work experience in a Customer Service function preferred
Accurate Keyboarding skills
High Speed Internet access for work from home capabilities

Care Coordinator Resume Examples & Samples

Facilitates patient and resource throughput, ensuring the optimum utilization of personnel, supplies and equipment
Meets daily with case managers and/or social workers to identify potential discharges and assure needed test are ordered and resulted and required consults have been ordered and completed
Completes discharge phone calls to all "high risk" patients
Reviews daily documentation of staff to assure it meets all regulatory requirements
Assists manager in patient rounding and service recovery
Acts as a liaison between Nursing, Physicians, House Staff, Ancillary Departments, Case Managers and patient/family members to assure adherence to timely facilitation of standards of care, while promoting appropriate care transition
Collaborates with Nursing Director to identify process issues and facilitate a plan for process improvement
Maintains current and up to date knowledge of CMS Core Measures and clinical documentation requirements for patient care
Collaborates with Case Management and other departments to expedite discharge, assuring all resources are made available to patients and teaching is complete prior to discharge
Proactively meets with Manager to discuss actual and/or potential non-routine technical, procedural, performance or personnel problems
Participates in unit/departmental Quality Improvement activities and reports findings as required
Participates in meetings such as patient care conferences, staff meetings, in-services, etc. as required
Implements Service Excellence strategies to improve the patient experience

RN Care Coordinator Resume Examples & Samples

Reviews medical records for appropriate application of medical necessity criteria to determine the appropriateness of admission and/or continued stay and readiness for discharge using
Performs concurrent clinical review for patients to ensure that extended stays are medically justified and are so documented in patient's medical. Communicates with attending physician regarding patients clinical condition, signs and symptoms as needed to ensure the patient’s admission status is supported by the physician’s documentation consistent with industry accepted guidelines and payer rules/regulations
Module when received by the patient’s payer
Participates in daily departmental planning meetings and meets with the clinical team to guide the patient’s discharge plan
Financial counseling agencies
Collaborates with the RN Care Coordinator, Care Coordination Social Worker and othermembers of the healthcare team regarding target length of stay (LOS), acute care criteria, pay requirements, resource utilization, and care options to meet patient needs
Participates in a regular rotation of weekend and after-hours coverage in order to meet
Department needs as determined by the Director of Case Management
Knowledge of Medicare and Medicaid payment rules, policies and regulations
Ability to work as a part of a team

Managed Care Coordinator Resume Examples & Samples

One (1) year medical terminology
Must have computer skills including data input around 60-70 wpm
Working knowledge of MS Office Excel and Word, other Managed Care related programs

Orthopedic Care Coordinator Resume Examples & Samples

Bachelor's degree in a relevant healthcare field required
3+ years of clinical orthopedic experience required
Experience in case management strongly preferred
Case Management organization membership desired
ABQAURP or CPHQ certification a plus
Proficiency in Microsoft Office Suite necessary

Care Coordinator Resume Examples & Samples

Required a High School or GED
Preferred an Associate's Degree in a related field
Intermediate knowledge of medical terminology and/or experience with CPT and ICD-9 coding
Intermediate ability to multi-task
Intermediate work effectively within group to achieve desired outcomes

Care Coordinator Resume Examples & Samples

Responsible for total coordination and processing of all patient referrals for specialty services
Follows protocols for proper authorization and processing of all referrals
Assists team in educating patient/family, follows JSA standing orders/protocols, assists patients with external resources when needed
Communicates with the patient on a timely basis for all scheduling requirements. Coordinates pre-admission testing requirements with clinic personnel and patient
Completes all administrative functions associated with referral activities in a timely manner
Enters all referral, hospital, outpatient, DME and other patient specialty health service authorizations into the computer system according to JSA policy and procedure
Responsible for monitoring all referral reports not received and timely follow-up in accordance with JSA policy and procedure
Minimum: Must be computer literate and have exceptional telephone skills
Preferred: Medical office experience with referral processing for HMO Previous medical office
Knowledge of HIPAA regulations
Results and goal-oriented with a philosophy for quality improvement
Must be computer literate and have exceptional telephone skills
Possess high job accuracy, efficiency, and dependability
Ability to travel locally may be required

Care Coordinator Resume Examples & Samples

Documents members’ service benefits by contacting the appropriate health plans as needed
Assists and monitors in the processing of referrals. Enters, updates and closes referrals daily while assuring that appropriate internal/external referral providers are utilized, members are eligible and have benefits coverage, correct CPT/ICD-9 codes have been entered, accurate records of all dates and other required fields are entered, supporting clinical data for the referrals is entered, and all urgent referrals are processed within the designated timeframe
Processes elective surgical requests including the coordination of surgery dates and notification of inpatient team, Hospitalist or Care Manager when appropriate
Works with Patient Services regarding member concerns
Processes referrals for inter-facility transfers using pre-established guidelines
Processes after-hours emergency/urgent care logs/lists as needed
Collects and prepares medical records for review when appropriate or as requested
Ability to type 30 wpm
Proven ability to problem-solve

Managed Care Coordinator Resume Examples & Samples

Work with IT to develop system enhancements relative to billing
Perform weekly audits of Master Files
Actively participate in QBS conversions and integrations
QC team members on regular basis Performs other related duties upon request
Verifies data to ensure information is accurate and has been keyed into the correct account
Works on projects independently. Prepares and maintains billing records for status reports
Ability to handle multiple tasks & meet deadlines within standards
Works well with all levels of associates and management
3+ years of healthcare billing experience
Experience using Microsoft Excel (creating/format spreadsheets) and Word (create/update documents)
Payor Management experience

Long Term Care Coordinator Resume Examples & Samples

Candidate MUST LIVE in HENDRY COUNTY - no exceptions
Bachelor’s degree / Registered Nurse License and 2+ years of care management experience or
Licensed Practical Nurse and 4+ years of care management experience or
High School Diploma and 6+ years of care management experience
Home health, discharge planning, or long term care experience preferred
RN or LPN License preferred
Bilingual (written & verbal) in English & Spanish is preferred

Long Term Care Coordinator Resume Examples & Samples

Candidate MUST LIVE in CITRUS COUNTY - no exceptions
Bachelor’s degree / Registered Nurse License and 2+ years of care management experience OR
Licensed Practical Nurse and 4+ years of care management experience OR

RN Care Coordinator Resume Examples & Samples

Concurrently reviews patient’s records to collect data to carefully understand the needs of the patient by scrutinizing their background history, understanding their current needs, and arranging for their wellbeing
Using industry guidelines, assesses appropriateness of hospital admission, level of care, and length of stay
Completes a comprehensive clinical interview with the patient, family members and/or care giver identifying problems or opportunities that would benefit from case management intervention such as over-utilization or under utilization of services, use of inappropriate services or level of care, non-adherence to plan of care, lack of education or understanding of disease process, language or cultural barriers, current condition(s) or medications, functional limitations, lack of support system or presence of a support system under stress, financial barriers, compromised client safety
Documents initial assessment within 48 hrs of patient, family or caregiver contact
Evaluates patients overall risk using risk stratification tools and determines if meets routine case management or complex case management criteria
Assesses physical, psychosocial and other needs to ensure individualized care plan captures patient's current healthcare needs, determining when Social Worker intervention is needed
Reviews medications and recognizes potential medication discrepancies and barriers referring to and coordinating with pharmacist in managing patient medication needs
Coordinates with other disciplines to facilitate the patient’s individual needs. Makes plans to resolve unexpected care requirements. Anticipates and identifies variances in the care process related to those identified needs
Assists in development, implementation and revision of individual treatment plans; assures that services provided are specified in the Treatment Plan and monitors progress toward treatment goals, including documentation of daily improvement in patient’s condition or otherwise notes lack of improvement for reassessment of appropriateness of treatment plan
Communicates with the primary care and specialist physicians, regularly, to evaluate the status of each patient. Collaborates with other team members to ensure appropriate interventions are implemented

RN Care Coordinator Resume Examples & Samples

Concurrently reviews patient records to collect data to carefully understand the needs of the patient by reviewing their background history, understanding their current needs, and arranging for their wellbeing
Completes a comprehensive clinical interview with the patient, family members and/or care giver identifying problems or opportunities that would benefit from care management intervention such as over-utilization or underutilization of services, use of inappropriate services or level of care, non-adherence to plan of care, lack of education or understanding of disease process, language or cultural barriers, current condition(s) or medications, functional limitations, lack of support system or presence of a support system under stress, financial barriers, compromising patient safety
Documents initial assessment within 48 hrs. of patient, family or caregiver contact
Evaluates patients overall risk using risk stratification tools and determines if meets routine care management or complex care management criteria
Communicates with the primary care and specialist physicians, regularly, to evaluate the status of each patient. Collaborates with other team members to ensure appropriate interventions are implemented. These communications will occur as frequently as is needed to ensure care is appropriate according to patient status
Measures effectiveness and outcomes of the care plan and collaborates with the health care team for quality improvement (primary care physician, social workers, pharmacists, home visit providers, care coordination support staff)
Teaches, coaches and educates the patient, family and/or caregiver about their disease process to recognize signs and symptoms of worsening disease and how to take appropriate measures
Assesses and makes referrals to appropriate community resources to facilitate patient progression toward expected goals/outcomes
Reports weekly to the Executive Director regarding patient status and identifies any potential risk management
Maintains case files and reports

RN Care Coordinator Resume Examples & Samples

Using industry guidelines, assesses appropriateness of admission, level of care, and length of stay
Communicates with the nursing home physicians, regularly, to evaluate the status of each patient. Collaborates with other team members to ensure appropriate interventions are implemented. These communications will be needed as frequently as is need to ensure care is appropriate according to patient status
Coordinates with other disciplines to facilitate the patient receiving the required care at the expected time including plan of care to reduce incidence or re-admission to acute care setting, including physical, occupational and rehabilitative therapy
Coordinates transfers to a lower level of care, home health referrals, and durable medical equipment delivery to facilitate discharge from skilled nursing facility
Measures effectiveness and outcomes of the care plan and collaborates with the health care team for quality improvement
Interacts with patient and family providing transition plan for treatment goals and post-discharge needs
Reports weekly to the Program Director for Quality and Care Management or Medical Director for Quality and Utilization regarding patient status and identifies any potential risk management

Managed Care Coordinator Resume Examples & Samples

College degree
General knowledge of workers compensation managed care industry. Excellent written and oral communication skills
Strong organizational skills-must be able to prioritize workload and manage multiple tasks simultaneously
Minimum 1 year of direct insurance industry experience
Proficiency in computer applications, including risxfacs.com, Outlook, Excel, Word, PowerPoint, and Access
Familiarity with Access or enterprise database programs is a plus

Continue the Care Coordinator Resume Examples & Samples

Expert ability to develop relationships with referral sources through the use of all communication channels deemed appropriate
Expert ability at collaborating with clinical personnel for a team approach to referral management and discharge planning
Proficient user knowledge of Windows Office programs (Word, Excel, PowerPoint), and the ability to learn specialized computer applications (Protouch, Point Click Care, HPAS, Meditech) that are specific to handling job requirements
Working knowledge (or the ability to learn) of healthcare reimbursement programs (payer sources)
Ability to develop professional working relationships and communicate effectively with multiple constituencies –Case Managers, Clinical Liaisons, Admissions Coordinators, external personnel, fellow Kindred associates, etc
Ability to work flexible hours, as admission responsibilities may dictate
Ability to perform the essential job functions of this job, with or without reasonable accommodations
3-4 years of experience in a sales/marketing position, or admissions office or with a heavy emphasis on customer service

Junior Contractor Care Coordinator Resume Examples & Samples

Hold a university degree
Are fluent in English
Are service and delivery focused
Are a team player
Have a keen eye for details and Can Do attitude
Can work to tight deadlines
Are self-motivated and able to work autonomously
Are well organised and methodical
Are highly responsive with ability to absorb information quickly
Are familiar with recruitment industry

Care Coordinator Resume Examples & Samples

Assess and identify participant’s readiness, identify educational needs, develop interventions and set goals for behavioral modifications within the scope of nursing practice
Conduct health and wellness coaching sessions to assist participants in making lasting changes to their health and wellness
Monitor and document patient’s progress towards goals
Communicate and act as a liaison with physicians and other health care professionals to provide care coordination
Help monitor quality incentives such as PCMH, PQRS, and Meaningful Use under direction of Quality Manager
Recommend policies and procedures that promote wellness and quality improvements
Coordinate and complete quality incentives promoted by insurance companies such as Gaps in Care with BCBS and Humana etc
Analyze clinical data and identify patient treatment opportunities for patients who have gaps in care
Remain current on industry trends, best practice operational models, and evolving patient and provider needs
Computer and/or Keyboard skills required
Exceptional communication skills and peer interaction, effective oral and listening skills with customers of various backgrounds
Excellent organizational abilities
Ability to adapt to with change
Excellent teamwork skills
Knowledge of patient examination, disease diagnosis and treatment room procedures
Knowledge of patient education principles and self-management techniques
Knowledge of common safety hazards and precautions
Skill in administering a variety of treatment and medications
Skill in measuring vital signs, including temperature, blood pressure, pulse, respiratory rate, pain assessment, and pulse

CCM Care Coordinator Resume Examples & Samples

Provides nursing care for routine occupational illnesses and injuries at a single worksite based upon medical directives and nursing assessments
Performs screening examinations such as, vision screening, tonometry and EKG to determine whether employees meet expected health standards of company. Refers abnormal or questionable findings to appropriate individuals for further evaluation
Assists with physical examination programs, obtaining health and work history, and interpreting results to ensure that appropriate referrals are made, when appropriate
Assists case managers on on-site injuries. Assists in determining extent or seriousness of work-related injuries. Administers basic first-aid and assistance and contacts appropriate authorities regarding decisions related to further actions
Tracks and records exposure to hazardous environments or chemicals and common injuries to ensure prevention of future occurrence. May assists in providing counseling on routine health subjects and referrals to other health care professionals
Maintains health related documentation such as employee medical records
Zero or more years of nursing experience
Experience working with medical procedures and techniques
Experience working with emergency medical techniques such as CPR and first aid
Experience working with company facilities
Ability to keep sensitive and confidential material private
Willingness to travel

Lifesource Transplant Care Coordinator Resume Examples & Samples

Manage the transplant referral process for NAC business
Ability to understand and interpret LifeSource transplant provider contract terms
Communicate with payor case managers and transplant program coordinators, as well as managed care personnel, on regular basis including getting zone dates, discussing transplant contracts, program statistics, answering questions and resolving claims issues
Document zones and case status in LifeSource database
Work closely with LifeSOURCE Claims Repricers to respond to questions about claims and ensure correct contract terms are applied
Work with Accounts Receivable department as requested for billing of access fees
Review claims as needed for transplant related versus non-transplant related services
Work with LifeSource Account Managers to resolve various issues and participate in implementation meetings, telephonically and on-site, for new clients and perform demonstration and training of Cigna LifeSOURCE website
Occasional travel with Account Manager to meet with existing and potential clients in person
At least 5 years experience in health care as case manager, transplant required
Nursing degree required
Highly motivated with excellent organizational skills
Self-starter with ability to work independently or as a team to achieve goals and objectives
Ability to work with matrix partners
Knowledge of transplant networks a plus
Competent in Word and Excel, Access is a plus
Presentation skills a plus

Care Coordinator Resume Examples & Samples

Obtaining documents from EMAR and Physicians
Chart Preparation
Discharge planning
Utilization Management / Case Management

100

Customer Care Coordinator Resume Examples & Samples

You will be allocated responsibility of ensuring that our customers receive a first class level of service on a set number of our new home developments
This will entail dealing with any concerns they may have at the demonstration, moving in and 5 day call back stage and throughout the contractual warranty period
You will need to arrange for some issues to be inspected and then to place orders with various sub-contract tradesmen to correct issues as part of your day to day role
We ask our customers for their views on the quality of our service after moving in and this feedback will help us to measure your success
The role will involve telephone contact, email and letter writing as part of your day to day tasks
Knowledge of the new homes industry / construction and relevant experience in a customer service environment is essential
They key to success in this role is the ability to be highly organised so that you keep any promises to get back to customers within promised timeframes
A positive outlook and a personable nature will be vital to the role as communicating effectively with customers, sub-contractors and internal colleagues will give you the best chance of delivering against your key performance indicators

101

Individualized Care Coordinator Resume Examples & Samples

Applies acquired job skills and company policies and procedures to complete standard tasks
Works on routine assignments that require basic problem resolution
Consults with manager or senior peers on complex and unusual problems
Effectively manage moderate to high call volume
Communicate effectively with patients, care-givers and clinicians in a pleasant and professional manner
Input patient data into the pharmacy information management system
Resolve patient/customer inquiries with the most effective response
Contact patients and clinicians to schedule refills
Assist patients who have high prescription coverage with co-pay and patient assistance programs
Display professional approach with team members at all times
Maintains knowledge of and abides by all HIPPA, Board of Pharmacy, and applicable federal and state regulations
Candidate must be a Pharmacy Tech with call center experience
Two-years of college experience required
Must demonstrate effective verbal and written communications, with a desire to provide superior phone customer service
Candidate needs to demonstrate initiative, time management, organizational skills, a professional demeanor and positive attitude
Must be willing to take on additional duties when needed
Knowledge of Microsoft Office

102

Hospice Spiritual Care Coordinator Resume Examples & Samples

Ability to work with different lifestyles, cultures, beliefs and values
Ability to network with communities, clergy, and congregations
Knowledge of and commitment to hospice philosophy of care

103

Customer Care Coordinator Resume Examples & Samples

Responds to incoming customer requests with a live voice and answers questions regarding technical, large or complex service issues
Works closely with Sales to coordinate New Home Presentation and New Home Delivery
Staffs 24-hour on-call emergency response service and contacts subcontractors in emergency situations
Inputs warranty costs according to standard accounting practices
Performs quarterly housekeeping and model maintenance audits
Updates weekly and monthly tracking spreadsheets
Generates subcontractor work orders, purchase orders and back charges as instructed
Supplies Eliant homebuyer and staff information for surveying after COE
Performs any miscellaneous administrative duties as requested, such as assembling procedure manuals, running options lists for walk-throughs, entering loan approvals, etc
Strong ability to multi-task
Minimum of two years of customer service or construction experience

104

RN Care Coordinator Resume Examples & Samples

Manage utilization and practice metrics to refine the delivery of care model to maximize clinical, quality and fiscal outcomes for the population
Implement monitoring systems for high-risk member to prevent and/or intervene early during acute exacerbations. Works with the primary care physician to ensure appropriate standing orders for acute exacerbation management (such as diuretic titration protocol)
Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population
Needs to be professional as well as knowledgeable, responsible, and accountable to manage patient care over the continuum and to assist in improving quality, cost, and patient/service satisfaction outcomes
Will be responsible for the assessment, planning and implementation process for a select group of patients in the outpatient setting
Must be organized with the ability to self-motivate and prioritize a variety of duties
Proficient in computer literacy including but not limited to the electronic medical record, electronic data entry, retrieval and report generation
Ability to work effectively with clinical and non-clinical staff
Demonstrates excellent communication skills
Demonstrates the ability to perform multiple tasks simultaneously
Ability to motivate others
Ability to work with people from diverse backgrounds and experiences
Ability to openly address and acknowledge observed issues and concerns
Demonstrates proficiency in basic computer skills, including accurate keyboard entry of data into relevant computer based databases and spreadsheets,
Attention to detail, and ability to be flexible in performing a variety of tasks
Demonstrated ability to complete projects within designated timelines and the ability to prioritize duties is required
Demonstrates proficiency with Microsoft Word and Windows & Excel, and the ability to learn various system software
Demonstrates ability to use basic office equipment, computer, fax machine, copier, calculator, etc

105

Care Coordinator Resume Examples & Samples

Oversee Inpatient member discharge plans. Act as liaison between hospital staff and the member’s family/support system/providers
Coordinate Outpatient care for members without a discharge plan, link members and their families to appropriate community supports and Outpatient treatment
Coordinate and oversee Outpatient referrals for integrated medical/behavioral health services to network practitioners based on practitioner specialty and member’s geographic, cultural and language preferences
Collaborate with Inpatient and Outpatient Case Managers in identifying and removing barriers to member compliance with Outpatient care
Track communication and correspondence for all members on caseload and maintain monthly reports on case disposition
Responsible for monitoring and reporting compliance with aftercare appointments for all members identified as having been admitted for Mental Health / Substance Abuse treatment
Maintains detailed records of members who have been admitted to Inpatient treatment from the point of discharge for up to 30 days post-discharge to monitor compliance with 7 and/or 30 day ambulatory follow up
Responsible for generating authorizations for facility-based, post-discharge follow up visits and maintaining accurate files for ambulatory follow-up notes submitted as evidence of a post-discharge visit

106

Care Coordinator Resume Examples & Samples

Assist members and providers with all levels of inquiries, problem solving, insurance information and general customer service
Staff all call center queues and adhere to performance requirements for call center response times, abandonment rates, and other productivity, schedule, and quality standards or metrics that may be established
Monitor the data in the clinical care management system, collaborating with provider community; escalate issues and concerns regarding care management to senior care managers according to policies and procedures
Act as a liaison with parents and the health community to ensure continuum of care and support for members
Knowledge of Microsoft Office and Microsoft Outlook
Must have strong analytical, problem solving and organizational skills

107

LPN Care Coordinator Resume Examples & Samples

Participates in in-service programs
Monitors assigned cases to ensure compliance with requirements of third party payer
One (1) years of experience as a vocational nurse

108

Customer Care Coordinator Resume Examples & Samples

Must be prepared and able to handle, with composure and tact, a high volume of repetitive customer interactions over the telephone in a fast paced, sales-oriented environment
Answering inbound telephone calls in a skills-based environment where transactions range from call transfers to more common, complex hotel, dining, event and entertainment, flight and golf reservations for all market segments of Beau Rivage and Gold Strike customers
Ensuring that customer requests for reservations and other services are met and confirmed; within the guidelines established by management
Work with Quality Coaches and Shift Supervisors to evaluate individual performance and make efforts to improve performance where the need has been indicated
Provide Shift Supervisors with important observations culled from many customer interactions, offering suggestions to improve process, product or service offerings
Must demonstrate scheduling flexibility, as required in an environment where schedules are based upon fluctuating inbound call volume (weekend and holiday shifts may be required)
Make complimentary decisions based upon evaluation of customer gaming play
Using pre-determined guidelines, issue complimentaries sent by database marketing via mail, email or outbound telemarketing
Assist with distribution of concert and event tickets at the Beau Rivage Ticket Office during scheduled show dates
Performs duties and responsibilities as directed by Supervisors and Manager
Previous PABX or multi-line phone experience
Have a pleasant voice and clear, articulate speech
Effective, demonstrable computer skills (beyond basic keyboarding)
Ability to multi-task and work well in a fast paced, team oriented environment
Knowledge of property management, reservations and player tracking systems along with proficiency in basic Windows and MS Office packages are considered a plus

109

Care Coordinator Continuum Hospice Resume Examples & Samples

Furnish Nurse Consultants and perform consulting services
Provide education and consulting services consisting of Collaboration with Facility’s Director of Nursing, Medical Director, Administrator or other designated by Facility, in developing and reviewing care coordination pertaining to residents with end-stage conditions and in creation or revision of policies and procedures regarding end-state care coordination
Assist Facility in reviewing, revising, and educating Facility’s staff on the process related to best practices affecting the provision of care of chronically ill and severely symptomatic residents in a skilled nursing facility that enhance the delivery of care to residents as needed
Assist Facility’s Staff in identifying residents, whose curative treatments, therapy and polypharmacy protocols or orders have not shown to be beneficial in promoting quality or length of life, improving activities of daily living functionality or mental well-being
Communication on a regular basis with administration regarding actions, recommendations and concerns of the Consultant
Assist Facility to acquire, maintain and apply knowledge of hospice services that relate to nursing treatment of residents with end-state conditions in the long-term care setting
Assist Facility in developing best practices related to nurse/resident and/or nurse/family communication and reporting in order to optimize care, control costs, and reduce number of unplanned hospitalizations of residents with end-state conditions in the long term care setting
Assist Facility in identifying residents as being in or approaching end-stage condition
Assist Facility’s staff in understand qualification of benefits of hospice services

110

Care Coordinator Resume Examples & Samples

3 years of clinical experience in discharge planning or case management
Ability to effectively use specialized computer-based systems for the gathering, reporting, and analysis of clinical data
Excellent organizational and communications skills
Utilization management and third party payer knowledge

111

Long Term Care Coordinator Resume Examples & Samples

Candidates must live in Crestview, FL – no exceptions
Bachelor’s degree / Registered Nurse License and 2+ years of care management experience (preferred) OR
Licensed Practical Nurse and 4+ years of care management experience (preferred) OR
Bilingual (written & verbal) in English & Spanish is helpful

112

Skilled Inpatient Care Coordinator Resume Examples & Samples

Registered Clinician is a requirement of the role with preference for RN, PT, or OT credentials
Independent problem identification/resolution and decision making skills
Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously
Ability to travel in a local or regional market depending upon facility alignment

113

RN Care Coordinator Resume Examples & Samples

If operational conditions permit, training a candidate without the required experience may be considered
Graduate of an RN School of Nursing. A Master’s Degree in nursing with a concentration in Case Management can serve as a substitute for the experience requirement. BSN degree or experience equivalent preferred
Current BLS Card

114

Care Coordinator Resume Examples & Samples

Education: Master's degree in social work, counseling or a behavioral health related field
Experience: none
License/Certification: LPC/LPCA, LCSW/LCSWA, MFT/MFTA and compliance with state board requirements for supervised practice while pursuing independent licensure
Physical Requirements: Physical ability to manage patients. Ability to exercise self-control in potentially volatile situations such as being verbally or physically confronted in a threatening or aggressive manner must be able to work and concentrate amidst distractions such as noise, conversation and foot traffic ability to handle interruptions often and be able to move from one task to another must be flexible and not easily frustrated in dealing with differences of opinions

115

Care Coordinator Resume Examples & Samples

2+ years of experience in providing case/care management services to persons who are elderly and/or person with physical or developmental disabilities
1 year experience in long-term care, home health, hospice, public health, assisted living, and or working with the elderly and physically disabled
Basic level of proficiency in Microsoft Programs (Word, Excel, Internet, Outlook)

116

Care Coordinator Resume Examples & Samples

Some work is completed without established procedures
Bachelor's level degree in Social Work, Human Services or equivalent
Bilingual in English & Spanish
Working knowledge or experience with HEDIS measures
Registered Nurse & Licensed Practical Nurse experience

117

RN Care Coordinator Resume Examples & Samples

After referral from external source(s), meets patient/family in patient’s home, provider office or facility and completes assessment, develops plan of care and goals to review with patient and family
May concurrently review patient’s records to collect data to carefully understand the needs of the patient by scrutinizing their background history, understanding their current needs, and arranging for their wellbeing
Communicates with the primary care and specialist physicians, regularly, to evaluate the status of each patient. Collaborates with other team members to ensure appropriate interventions are implemented. These communications will be needed as frequently as is need to ensure care is appropriate according to patient status
Reports weekly to the Program Director for Care Management regarding patient status and identifies any potential risk management
Maintain case files and reports

118

Pediatric Rheumatology Care Coordinator Resume Examples & Samples

Conducts comprehensive clinical assessments that include disease-specific, age-specific, medical, behavioral, pharmacy, social and end of life needs of each patient
Monitors patient compliance with plan of care. Performs reassessments regarding patient progress toward goals and updates plan of care as appropriate. Ensures care gaps are closed around specialty disease/chronic disease
Identifies barriers to receiving care and facilitates solutions
Coaches patient and family on self-management support, including setting long and short term goals (including acute exacerbation management)
Ensures patient satisfaction, readmissions, cost per case, and compliance with care paths or evidence based guidelines
Three to five years of nursing experience required

119

Care Coordinator Resume Examples & Samples

Ensures receipt of a valid authorization for each request
Supports the preparation for audits and data requests
Assists with manual data entry
Maintains database of information for area of responsibility
Assists in the preparation of reports
Answers, screens and transfers telephone calls
Maintains schedules by coordinating with appropriate parties
Add Other Details Specific to this Coordinator Role
Over 2-5 years of experience within specific job and/or department
10-key skills
Filing skills
Ability to work on multiple assignments and manage time effectively
Ability to work effectively with people at all levels of the organization

120

Hospice Care Coordinator Resume Examples & Samples

Ensuring continuity of care, smooth interaction, and communication between all involved in patient care activities
Managing all aspects of organization marketing including managing the members of the marketing team
2 years of experience in sales or public relations in a hospice/ home health care company

121

Medical Care Coordinator Resume Examples & Samples

Perform day to day activities required for PA processing and follow defined business rules and policies, including timeliness requirements for transportation services
Collaborate with other OMS Units to resolve claims issues that involve PA’s
Respond to questions and concerns from interested parties regarding PA criteria and processes
Be responsible for communications to providers, members, and others via phone, fax and mail
Perform basic research on medical conditions, medical services and health care providers

122

Pulmonary Care Coordinator Resume Examples & Samples

Develops implements, coordinates and evaluates an education program for patients with community acquired pneumonia (COP), COPD or CHF
Coordinates patients' Plans of Care in compliance with regional best practice guidelines and in conjunction with multi-disciplinary care team, including Action and Management Plans
Assesses status and compliance with Plans of Care for all patients with COP, COPD or CHF after hospitalizations, HOPS stays or emergency room visits
Under the supervision of a Pulmonologist, gives telephone advice
Provides in-hospital respiratory consulting to recommend an education plan prior to discharge of a patient to home health, nursing home or the outpatient environment
Acts as a resource to the health care team regarding patient education, occurrence reporting and quality assessment
Coordinates a respiratory education program for the public schools and the community promoting continuity, developing awareness and direction especially for those at risk for increased pulmonary related illnesses
Minimum five (5) years of respiratory care experience in an acute clinical setting
Experience facilitating performance improvement projects and experience planning, coordinating and implementing programs within the last three (3) years preferred
Experience in patient education in respiratory disease and sleep disorders within the last three (3) years preferred

123

SW Field Care Coordinator Resume Examples & Samples

Determines member’s overall bio-psychosocial needs and develops individualized member service / care plan including long term care services and supports based on assessment data, member and caregiver / stakeholder input, and cost-effective options for service delivery
Bachelor's level degree in Social Work or RN licensure in the state of KS
Experience working with Intellectually Developmentally Disabled population (IDD)
Computer / typing proficiency to enter / retrieve data in electronic clinical records; experience with email, internet research, use of online calendars and other software applications (Word, Excel, Internet, Outlook)
Master's degree in Social Work
Experience in Home & Community based or Long Term Care services delivery, or Waiver Program
Experience with electronic charting

124

Care Coordinator Autism Resume Examples & Samples

Assist members and providers with all levels of inquiries, problem solving, insurance information and general customer services
Staff all Call Center queues and adhere to performance requirements for call center response times, abandonment rates, and other productivity, schedule and quality standards or metrics that may be established
Receive, respond and resolve questions about accessing ABA services
Monitor data in clinical care management system, collaborating with provider community, escalate issues and concerns regarding care management to Senior Care Managers according to policies and procedures
Participates in corporate quality improvement functions
Assists with special projects and administrative tasks as assigned
Knowledge or ability to learn state and federal laws and regulations applicable to call center is desired
General knowledge of Microsoft Office Suite: Outlook, Excel and Word
General knowledge of clinical documentation, preferably electronic health records/medical records systems
Ability to recognize and or anticipate the needs of customers and respond accordingly
Must be self-directed and resourceful

125

Long Term Care Coordinator Resume Examples & Samples

Candidate MUST LIVE IN COLUMBIA COUNTY - no exceptions
Bachelor’s degree / Registered Nurse License AND 2+ years of care management experience OR
Licensed Practical Nurse AND 4+ years of care management experience OR
High School Diploma/GED AND 6+ years of care management experience
Candidates must be able to attend required LTC training class (duration 4 weeks) in any one of our FL offices (Tampa, Sunrise, Jacksonville, Maitland)

126

Individualized Care Coordinator / CSR Resume Examples & Samples

Investigate and resolve patient/physician inquiries and concerns in a timely manner
Responsible for handling inbound calls, with ability to determine needs and provide one call resolution
Be knowledgeable in insurance billing methods and general pharmacy operations
Demonstrate superior customer support talents
Prioritize multiple, concurrent assignments and work with a sense of urgency
Must communicate clearly and effectively in both a written and verbal format
Adaptable and Flexible
Self-Motivated and Dependable
Team Spirited with great work attitude
Punctual and Efficient
1-3 years related experience and/or training desired or equivalent combination of education and experience is preferred
Experience should include knowledge of practices and procedures commonly used in a call center or customer service environment
Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies is preferred
Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred

127

RN Care Coordinator Resume Examples & Samples

The RN Care Coordinator establishes and documents a working DRG on each assigned patient at the time of initial review to estimate a targeted length of stay and anticpate the date of discharge for planning and care coordination purposes
The RN Care Coordinator completes and documents a discharge planning assessment on those patients identified as high or moderate risk by the designated screening process, or upon the request of a physician, NP, PA or patient representative
The RN Care Coordinator facilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members, the patient or patient representative and post acute care providers in accordance with the patients clinical or psychosocial needs, choices and available resources. The RN Care Coordinator initiates then initiates the plan to facilitate a safe and appropriate care transition
This position will work closely with all departments at the medical center and the post-acute service providers to streamline the patient transition through the health care system and into the community post discharge
The RN Care Coordinator participates regularly in Medical Center, departmental, hospital or team meetings pertinent to the accountable areas, and also participates in performance improvement teams and programs as necessary
This position requires the full understanding and active participation in fulfilling the Mission of the Organization. It is expected the RN Care Coordinator will demonstrate behavior consistent with the Core Values of the organization
The RN Care Coordinator is accountable for staying current with and seeking knowledge of hospital policies, standards of practice and Federal or State regulations pertaining to their practice
In addition, this position considers the population served by the medical center and area clinical integration programs and leads efforts to optimize care coordination across the care continuum. This coordination ensures a plan of care for patients in all stages of health needs
Prior Care Coordination experience in a clinical or insurance setting is required. If operational conditions permit, training a candidate without the required experience may be considered

128

Clinical Care Coordinator Resume Examples & Samples

Coordinate care for assigned caseload as directed by the Care Manager
Monitor and update the Individualized Care Plan (ICP) for assigned caseload
Communicate all changes to the Interdisciplinary Care Team and others involved in the actions described in the ICP
Management and coordination of care. May conduct in-home assessments of barriers to health condition management and conduct facility visits to meet members receiving in-patient behavioral health care to assist with discharge planning and engagement activities
Secure outpatient appointments for the member and facilitation of home and community based services
Support safe transitions in care for members moving between settings
Support adherence to the elements of the ICP
Assist member in navigating the network of community based services and information
Identify and report quality of care issues and identify communities that require additional providers
Identify need for interpreter services, and provide self-management and other materials in preferred language and formats
Facilitate communication between the member or designated representative and the Medical Lead (PCP or psychiatrist) and other healthcare providers, including transition of care activities
Work with the Beacon contracted community based Case Management agency to facilitate coordinated care as delegated
Assist in data collection related to member care as directed
3-5 years’ experience in community based behavioral health support programs
Knowledge of Microsoft Office Suite (Word, Excel, PowerPoint)

129

Care Coordinator Resume Examples & Samples

Management of reimbursement and resources
Monitors financial outcomes to assess potential aspects of cost reduction
Cost effective methods of ensuring and/or improving care are established, implemented and managed
Negotiates and procures services and supplies to meet patient needs in a timely manner
Conducts admission utilization and concurrent continued stay reviews
Communicates concurrently with coders and physicians to assure that documentation reflects the appropriate diagnosis and DRG coding
Provides accuracy to billing/reimbursement process
Management of referrals and transitions
Conducts discharge planning assessment within 24 hours of admission
Conducts discharge planning activities
Identifies and refers to community agencies for emotional, physical, psychosocial or spiritual health needs
Finalizes discharge plan with patient/family
Identifies pre and post hospitalization patient needs
Development of physician partnership
Provide data to support ideas and expertise to implement changes for cost effective care
Models nursing practice by assessing, monitoring, detecting, diagnosing and treating the

130

Care Coordinator Resume Examples & Samples

Required - High School or GED
Preferred - Associate's Degree in a related field
Required - 3+ years of experience in a managed care setting, medical office or facility setting with demonstration of medical administration duties
Knowledge of medical terminology and/or experience with CPT and ICD-9 coding
Proven ability to multi-task
Ability to work effectively within group to achieve desired outcomes
Licensed Practical Nurse (LPN) preferred
Required - Intermediate proficiency working with Microsoft Word, Excel and Outlook

131

Administrative Care Coordinator Resume Examples & Samples

Some post secondary education, office training or administrative assistant skills
Two years’ experience with computer office applications, office work and/or administrative staff support in a clinical or pediatric setting
Keyboarding skills of 55wpm. Microsoft Office skills including Word, Excel, Office, and good internet usage skills
Effective written/verbal/ interpersonal communication skills. Adaptability. Ability to stay focused amidst frequent interruptions. Outstanding organizational and customer service skills. Ability to multi-task and meet deadlines. Collaborative and problem solving skills. Initiative

132

Care Coordinator, Bexhill, Bexhill Resume Examples & Samples

Direct line management for a team of Home Care Workers, including the management of their weekly workload
Defining special care needs based upon identification of specific clinical problems and to monitor and review as appropriate
Reporting to a Branch Manager on a weekly basis on activity levels and outcomes for service users

133

Amb Care Coordinator Resume Examples & Samples

"Provides superior customer service to internal and external clients, customers, and patients as referenced in the NCQA Patient-Centered Medical Home and Service Excellence Standards."
Assists patients with self-motivation efforts to help patients manage their care
Distributes appropriate teaching materials to patient/family to review
Coordinates referrals and resources, including Diabetes Center, VNA referrals, DME, meals on wheels
Assist with tracking quality and preventive screening measures
Assists with patient outreach
Schedules test per written SEHC workflow with SEMC Central Scheduler via telephone or electronically
Coordinates patient flow throughout all scheduled departments
Notifies SEMC Central Scheduler when Interpreter services are needed
Responsible to keep up with changes in departmental hospital regulations, policies, and procedures
Shows respect for patient privacy by following established HIPPA guidelines
Follows Joint Commission policies and procedures, including the National Patient Safety Goals
Processes Prescription Prior Authorizations
Knowledge of health insurance compliance

134

Customer Care Coordinator Resume Examples & Samples

Responds to incoming customer requests with a live voice as well as by email and answers questions regarding technical, large or complex service concerns
Generates subcontractor work orders, purchase orders and back charges
Performs miscellaneous administrative duties, such as assembling procedure manuals, enters data in the homeowner lot files
Keeps lot files up-to-date by scanning and filing printed documents, as well as copying digital information
Reviews invoices for completed service work
Strong ability to multi-task and stay organized

135

Joint Care Coordinator Resume Examples & Samples

Collaborates closely with The Joint Replacement Academy Medical Director and physician champions for the programs. Coordinates daily delivery of joint replacement services to provide quality patient care. Reviews, plans and implements policies and procedures of the program; monitors their effectiveness and ensures compliance with appropriate governing agencies
Conducts daily rounds on patients in The Joint Replacement Academy, assessing and ensuring accurate and timely delivery of the patient care program. Monitors patient satisfaction with care, education, and overall program effectiveness
Coordinates discharge plans with physicians, physical therapy, nursing and case management, ensuring patient education, equipment, discharge disposition needs are addressed
Coordinates implementation of best practice protocols for joint replacement care, including pre- and post-op and discharge order sets, and standardized plans of care (anesthesia, pain, nausea, vomiting, etc). Provides staff development, problem resolution, and protocol performance for program efficacy
Oversees the ongoing quality improvement plan by collecting and maintaining data, utilizing established measures for monitoring quality. Presents key data and statistical information to appropriate audience. Conducts overall analysis of the joint replacement program, data, participates in the development of improved methods of care
Coordinates the development and creation of pre- and post-op teaching classes (including teaching materials) with the physician’s office and ensures appropriate patient and family pre-op preparation

136

Clinical Care Coordinator Resume Examples & Samples

Must have effective verbal and written communication skills to communicate in a clear, concise manner with patients, families, physicians, referral sources, hospital staff, and the public, as well as provide accurate and timely documentation and record-keeping
Must be thoroughly conversant with the principles of utilization review and quality assurance
Stable emotional makeup is required to interact with patients, physicians, and hospital personnel
Good organizational and time management skills are required to cope in a fast-paced environment with frequent interruptions, complex schedules, and fluctuations in census
Physical demands include daily sitting, standing, walking, and movement, as well as meeting patients and families

137

Managed Care Coordinator Resume Examples & Samples

Compiles appeal documentation for timely submission to the insurance carriers
Identifies payments in the PAS systems
Validates account details as part of required pre-audit functions, including routing of denials to the appropriate team, completing routine account entry and validating account details with payers through telephone calls
Ability to travel with own car for local/sometimes urgent travel
Demonstrates strong organizational and multi-tasking skills
Demonstrated ability to work in a team environment that requires quick turnaround and quality output
BA/BS in business or related concentration, preferred

138

Care Coordinator Resume Examples & Samples

Answer all calls
Gather information for the department professional staff
Telephonic and written outreach and data entry for member Health Risk Assessments (HRA) completion
Perform care transition activities for ONECare members as required with written and telephonic communication to members and providers
Disseminate educational materials
Schedule Nurse calls if needed and make warm telephone transfers to the nursing staff or social worker
Schedule provider appointments if needed
Follow up calls to members
Increase the number of incoming and outgoing member contacts
Problem solve issues under the direction of the Lead Care Coordinator
Knowledge in medical terminology, ICD-9/10/CPT Coding
Minimum of 2 years medical office experience
Excellent customer service and listening skills
Flexibility and adaptable to quick changing environment
Ability to work as team player in a professional environment
Able to receive direction from Medical Professional Staff
Good problem solving skills and knowledge of AHCCCS Managed Care and Medicare
Solid computer skills and ability to use the computer effectively in health plan business

139

Customer Care Coordinator Resume Examples & Samples

Trains call center staff on standard Customer Care processes, behaviors and standards
Handles and resolves escalated customer queries, problems and complaints
Monitors the performance of the call center staff against key performance standards
Provides recommendations for the continuous improvement of call center processes and service
Serves as the point of contact for call center leader regarding open requests, work orders, etc
Answers incoming Customer Care telephone lines; asks probing questions to gather facts; troubleshoots to resolve customer issues
Tracks and monitors appointments as required
Prepares and processes warranty work orders and inspection requests
Provides general administrative support for department including routine processing of correspondence from rough or revised drafts, data entry, preparation of reports, filing, copying and maintenance of service files. May compile and verify information for reports
Provides all customers - homebuyers, company colleagues, and all outside business associates - with consistent and exceptional service

140

Care Coordinator Resume Examples & Samples

Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple, clinical, social and community resources by
Implementing, coordinating, and monitoring strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for member’s care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan
Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member’s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases

141

Licensed Care Coordinator Resume Examples & Samples

Conducting in depth health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters
Communicating and developing the treatment plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to home care, back up plans, community based services)
Implementing, coordinating, and monitoring strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for member's care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan
Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; collects clinical path variance data that indicates potential areas for improvement of case and services provided; works with members and the interdisciplinary care plan team to adjust plan of care, when necessary
Educating providers, supporting staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services
Facilitates a team approach, including the Interdisciplinary Care Plan team (ICPT), to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, member's legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Utilizes licensed care coordination staff as appropriate for complex cases
Complies with Case management Society of America Standards for Case Management Practice and with CCMC code of Professional Conduct for Case Managers

142

Care Coordinator Resume Examples & Samples

Monitors the provision of services as outlined in the ICP and achievement of desired outcomes
Manages assigned case load
Participates in the HRA process

143

Customer Care Coordinator Resume Examples & Samples

Interface with customer’s to establish fit between customer requirements and SDM production capabilities
Ensure the customer provides proper data for project engineering to provide a quote
Front end on Alivechat for SDM customers
Creating a memorable experience for our customers on initial contact
Acknowledge all customers that inquire via phone call, Alivechat, RFQ bin/PEforce and/or Online Quoting portals with a warm transfer to the appropriate party
Field customer calls and questions
Assist sales in transferring quote requests to qualified project engineers
Provide quality customer care internally as well as externally to our customers
Identify, resolve or escalate any disputes that may arise between SDM and its customer
Minimal knowledge of IQS and SolidJobs
Demonstrate commitment to Stratasys Core Values by leading, acting and behaving in a manner consistent with these values
Perform other tasks as required by the Project Engineering Supervisor or Manager
Follow all safety policies and procedures and attend all safety trainings to the job
Candidate must be a U.S. citizen or permanent resident
High School education or GED; Post-secondary education desired
Minimum 2+ years of customer facing experience
Minimal understanding of or experience with manufacturing processes, and/or SDM capabilities
Must be self-motivated, and be able to work effectively on projects with minimal direct supervision
Ability to independently organize and prioritize multiple duties required
Good verbal and written communications skills, while maintaining a good working relationship with the Account Managers, customers and internal employees is required
Creativity and willingness to gain an advanced understanding of rapid prototyping applications are desired attributes
This position requires a customer-focused attitude with a high sense of urgency and attention to details when handling processes and machine related issues
Thorough understanding of Microsoft Office products i.e.; Word, Excel, Outlook
Ability to work well with others
No direct reports

144

Customer Care Coordinator Resume Examples & Samples

Effectively and enthusiastically communicate with homeowners and professionally address their questions and/or concerns
Receive and process homeowner service requests in a timely manner per established ROC processes
Have the ability to utilize multiple operating systems concurrently. CRM, Build Pro, Box
Support construction and customer care associates in all divisions with efficiency and urgency
Professionally communicate with multiple associates within all supported divisions
Meet or exceed daily/weekly deadlines as projected by management or as requested by the division
Flexible in taking on new assignments within the department
Process and review extra purchase orders for accuracy and approvals

145

RN Care Coordinator Resume Examples & Samples

Masters Degree in nursing with a concentration in Case Management can serve as a substitute for the experience requirement
Current CA Registered Nurse (R.N.) license
Excellent customer service and presentation skills, strong interpersonal and written communication skills, demonstrated ability to apply analytical and problem solving skills, and demonstrated ability to manage multiple tasks or projects effectively
Ability to work independently as needed with a high degree of detail orientation. And an ability to work efficiently in a fast-paced environment with changing priorities

146

Care Coordinator Resume Examples & Samples

Current active unrestricted clinical license required
3-5 years of clinical experience required
Experience working with geriatric population preferred
Strong problem solving, conflict resolution and negotiating skills

147

Care Coordinator Resume Examples & Samples

Manages assigned caseload with limited supervision
Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast paced environment
Compiles file documentation requiring extensive policy and factual detail
Identifies information and resources needed to make benefit eligibility determinations
Communicates decisions to policyholders and or their representatives in both verbal and written form
Clarifies and reconciles inconsistencies
Conducts in depth detailed information-gathering phone calls that obtain medical condition details and other information
1-2 years of related business experience or 3 years of LTC experience
Strong customer satisfaction focus

148

Care Coordinator / Bh-rocky Point Resume Examples & Samples

Responds to phones as assigned or team coverage as directed by Supervisor
Assists, completes and submits special projects, reports or assignments to meet department needs and objectives
Organizes a variety of administrative and clinical tasks and prioritizes in order of importance and impact on members and providers
Interacts with other departments including Claims, Intake, Enrollment and Member Services to resolve member and provider issues

149

Point of Care Coordinator Resume Examples & Samples

Good Organization Skills. Ability to prioritize work and handle multiple projects/tasks
Knowledge of State and Federal regulations as well as Joint Commission and CAP requirements as it pertains to POCT/waived testing
Proficient with MS Office, including Word, Excel, Outlook and Internet
Ability to communicate effectively and professionally, both orally and in writing
Must be able to read, speak and understand English
Must be able to work and make decisions independently
Ability to maintain confidential/sensitive information
Must be able to work with a high interruption level
Must be able to grasp abstract concepts

150

Care Coordinator Resume Examples & Samples

Ability to interact effectively and collaboratively with physicians, discharge planners, health care team members, individuals and members of their support systems
Familiarity with electronic health record systems and health information exchange
Third party payer payment methodologies
Proficient computer skills – data entry, Power Point, Excel, Word, retrieval and report generation
Navigating and accessing community and system resources
Effective interpersonal relations and bridge building skills
Written and verbal communications skills

151

Customer Care Coordinator Resume Examples & Samples

Generate documents such as memos and reports, establishing new formats where required
As authorized by requestor, edit punctuation, spelling, grammar and syntax, and proofread results for accuracy
Compose correspondence for signature, in response to routine inquiries. May take dictation
Use a variety of software packages such as word-processing, spreadsheet, database and graphics, to produce products that typically require applying new formulas and formats, or manipulating data
Screen and organize mail, determine priority, highlight important items and attach relevant information
High School diploma or GED and 2 years of experience
15 years administrative experience
Candidates must already have a work authorization that would permit them to work for ABB in the US

152

Care Coordinator Resume Examples & Samples

Answer/handle incoming phone calls and emails in a timely manner
Copying, typing, faxing, sending/receiving and distribution of emails/documents
Learn and develop proficiency with A2C Transportation computer application
Assist with managing recurring, short notice and future trip scheduling
One year of previous inbound call center experience or dispatcher preferred
Experience in a high stress and high call volume center preferred
Prior dispatch/routing experience is preferred
Effective oral, written and interpersonal communication skills
Excellent organizational skills with attention to detail
Proficient in Microsoft applications (Word, Excel, and Outlook)
Ability to multi-task with minimal supervision
Healthcare industry experience is preferred
Multilingual capabilities a plus

153

Customer Care Coordinator Resume Examples & Samples

Respond to guest feedback across the many different information highways (phone, email, website feedback, etc.) – defusing complaints, making believers out of folks new to Noodles and encouraging our loyal guests to come see us more often
Managing guest feedback database, including growing our database of guest responses that may be reused on a regular basis and monitoring unresolved cases
Identify and recommend process improvements; we want our guests to have a great experience in every point of contact and are looking for the best, most efficient ways, to handle guest feedback
Identify consumer trends and partner with operations to provide solutions and resolve issues
Act as a liaison between marketing, operations, training, restaurants, and supply chain to streamline guest feedback
Help to create and implement a Customer Care reporting system to bring visibility and awareness to trends and opportunities for improvement
Strong customer service background
Ability to comfortably speak with internal and external contacts
Familiarity with Microsoft Office

154

Team Lead Care Coordinator Resume Examples & Samples

Staff phone queues and adhere to telephone performance requirements
Complete Pre-Review Screenings per guidelines
Check personal voice mail and return calls within 1 business day
Verify patient benefits and eligibility through health plan computer access, phone and e-mail
Obtain appointments within established time frame guidelines
Check e-mail to stay informed of procedures and communicate with team members
Assist Clinical supervisor in monitoring phone standards (phone audits)
Assist with questions, concerns or difficult queue calls
Work with health plan, and providers to effectively coordinate patient care
Treat callers calmly, gracefully and directly with good communication skills
Attend all department and general staff meetings
Forward patient and provider complaints per health plan guidelines
Minimum 2 years of supervisory experience
Accurate and fast computer skills
Knowledge or ability to learn state and federal laws and regulations applicable to the call center is desired
Outstanding interpersonal skills needed to frequently interact with members, families, providers and insurance representatives to address a variety of concerns and requests
General knowledge of Microsoft Office Suite: Outlook, Excel, and Word

155

Customer Care Coordinator Resume Examples & Samples

Meet with homeowners to determine what actions are necessary to provide professional service based on our warranty guidelines
Ensure that subcontractors are managed and continually evaluated on quality, safety, scheduling and cost control measures
Manage contractor invoices as required by accounts payable
Provide a superior level of customer service during each interaction with our homeowners
Ensure that the all warranty work is completed in a professional manner and is satisfactory to the homeowner
Foster a team environment to ensure that effective communication, coordination of activities, and effective problem solving can occur
Ensure that the customers and their homes are respected by the contractors and that they work quickly and efficiently
Bachelor’s degree in Communications, Business or other related field OR have a minimum of 2 years of current or recent experience as a Customer Service Representative with a production homebuilder
Articulate communication skills and ability to insure customer satisfaction
Computer skills and ability to adapt to company systems
Ability to multi-task and stay focused

156

EAP Care Coordinator Resume Examples & Samples

Track and follow up with assigned members ensuring to adhere to established Standard Operating Procedures (SOP) which may include contacting member to ensure appointments have been scheduled and obtaining feedback on affiliate counseling services
Coordinate efforts to thoroughly document after hours member calls in the appropriate databases ensuring the case is assigned to the correct staff member
Participate in invoice investigation for assigned clients or members which may include researching insurance plan coverage and billing details
Assist in resolving routine issues by identifying issue(s) and researching in a timely manner
Consistently strive to provide highest levels of client satisfaction during each point of contact with client
Minimum of two years of customer service, health care, or case work experience is required
Completion of a Bachelor's degree from an accredited college or university with major coursework in psychology, behavior health, health care management, liberal arts or a related field may be substituted for work experience

157

Customer Care Coordinator Resume Examples & Samples

Two years coal experience preferably within a laboratory environment
Commercial document training
Computer skills in Word, Excel and CCLAS
Excellent time management skills to handle tight and pressured deadlines
Dealing with problems and pressures from customer demand
Microsoft office, spread sheeting, work documents and database use
Telephone system use
Familiarity with analytical procedures for coal
Strong coal analysis experience, data interpretation
Taking responsibility and accountability for work performed
Teamwork and cooperation
Effective communication
Ability to work unsupervised and be proactive in the completion of designated tasks
Organisational skills
Precise and accurate
Ability to accept constructive criticism

158

Customer Care Coordinator Resume Examples & Samples

Coordinate division response to customer warranty calls
Receive initial customer requests for service
Conduct initial analysis of customer issue to triage and determine appropriate course of action
Coordinate Customer Care Manager response
Document requests in service and scheduling system
Process work orders in accounting system
Effectively manage large amounts of incoming calls
Build sustainable relationships of trust through open and interactive communication
Handle complaints, provide appropriate solutions and alternatives within the time limits, and follow-up to ensure resolution
Assist in determining and documenting root cause
Track and report division service levels, satisfaction, response rates and costs
Ensure division complies with service history information and company retention requirements
Support claims/risk filings
Perform related administrative duties, as assigned

159

Wound Care Coordinator Resume Examples & Samples

Assesses, plans, implements and evaluates patients with a variety of conditions of the integumentary, gastrointestinal, urinary systems in the inpatient setting for the patient's skin and wound care needs
Acts as the primary consultant providing consultation and guidance for the bedside nurse in caring for patients with skin and wound care needs
Utilizes expertise in wound care assessment and management including pathophysiology, evidence based practice and current treatment modalities
Updates knowledge of best practices and functions independently in collaboration with the various physician services
Provides education for caregivers in the areas of pressure ulcer prevention, wound management
Participates in monthly pressure ulcer prevalence survey; processing data obtained from the survey in collaboration with the Quality Manager, utilizing data to make practice improvements
Identifies processes requiring quality monitoring
Reviews and provides consultation and recommendations regarding facility wound product formularies, supports surface rental process
Works with product reps to coordinate education on products
Two years current or recent experience in wound care management of wounds position
Five years experience as a nurse

160

Intake Field Care Coordinator Resume Examples & Samples

Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the healthcare team
2 years of clinical or case management experience
Experience evaluating and submitting PASRRs and Pre-Admission Evaluations (PAEs)

161

Care Coordinator Resume Examples & Samples

Act as representative of myConnections to both consumers and community partners
Conduct intake and follow up with consumers, using software on a tablet and PC, to establish rapport and trust as well as assess most urgent needs
Refer consumer to appropriate social services provider based on intake information, consumer socioeconomic status, and consumer’s schedule
Understand the target population through experience by integration into to the local community
Recognize local social service providers that connect with target population through community relations
Function as an advocate for consumers
Collaborate with onsite Navigators to ensure coordinated plan is implemented for each consumer
Ensure intakes and referrals are documented in a timely manner
Contribute to community education and outreach efforts
Fluent in both English and Spanish
Bachelor’s degree in healthcare, social work or related field
2+ years’ experience in healthcare, behavioral services, case management and social services
1+ years’ experience in customer service / support
Basic level of proficiency with Microsoft applications such as (Word, Excel, Outlook) and Internet
Access to reliable transportation to travel to implementation sites within a designated area
Able to work in the field and travel 25-50% of the time
High level of interpersonal and conversational skills
Willingness and adaptable to changing technology
Attention to detail and follow up
Medicare / Medicaid knowledge and experience
Ability to be flexible and adaptable with daily process
Resided within the local community for 2+ years
Field-Based experience

162

Care Coordinator Resume Examples & Samples

Analyze and process claims in a productive environment through our TLC claim system
Appropriately interpret a variety of plan provisions and process claims accordingly, calculating claim payments and overpayments
Review claims for receipt of all needed documentation and make outbound calls to providers for additional information
Collaborate with our Claim Support Specialists, Customer Call Center and Care Coordinators to provide a seamless claims experience
Abide by department guidelines and appropriately follow up on necessary tasks to process claims
Meet quality review standards of processed claims
Meet performance standards for financial accuracy, processing accuracy and claim timeliness
Respond to insured inquiries regarding specific claim details via telephone conversations and/or written correspondence
Gather and analyze information skillfully to identify and resolve problems in a timely manner
At least 2 years experience in a claim environment
Associate level or higher degree preferred
Excellent analytical and mathematical skills
Ability to pay attention to detail
Ability to comprehend and apply varied rules to multiple policies
Works well in a team environment
Proven ability to meet quality and time standards
Basic knowledge of computer system, Microsoft Word, and Excel

163

Clinical Care Coordinator Resume Examples & Samples

HS Diploma or equivalent education/experience (3-5 years progressively more responsible related work in the healthcare field)
At least one year post high school education (jr college or university)
Graduate of an accredited Medical Assistant program

164

Transitional Care Coordinator Resume Examples & Samples

Works collaboratively with the inpatient and outpatient health care team to coordinate seamless care for clients customized to their individual situations and needs
Collaborates with client and family health care providers and agencies using a multidisciplinary and holistic approach to help the client and family set realistic and achievable goals to achieve the desired outcomes
Utilizes professional and community knowledge and influence to obtain resources in the most cost

165

Care Coordinator Resume Examples & Samples

Monitors patient outcomes, optimizing resource utilization and implementing continuing care plans to meet patients' post-discharge needs
Reviews patients one business day after admission to determine medical necessity and appropriateness referencing InterQual Criteria severity of illness and intensity of service for admission in an acute care setting and reassesses cases at a minimum of every 48 hours for and continued stay referencing InterQual criteria intensity of service in an acute care setting
Utilizes chart review, electronic medical record, patient/family interviews, and interdisciplinary team as information sources
Organizes, plans and prioritizes caseload to optimize care coordination; provides intense case management for patients with high risk factors
Evaluates discharge planning needs on admission review. Collaborates with patient/family, physicians, nurses, ancillary personnel and external agencies to develop safe, individualized, and appropriate continuing care plans
Obtains consent from patients for continuing care providers; initiates timely referrals, discharges, and transportation arrangements
Ensures appropriate information is provided to anyone responsible for continuing care support
Identifies appropriate hospice candidates and communicates with physician regarding options
Reviews observation patients each day to determine appropriate level of care and patient status; confers with Admitting and Business Office departments regarding authorization issues as needed
Evaluates use and scheduling of hospital resources and intervenes to prevent over/under utilization
Identifies opportunities to prevent avoidable days and reduce length of stay
Participates in development of interdisciplinary care plans and documentation of patient education
Identifies educational needs of patients, families and staff and takes appropriate actions; assesses readiness for understanding and assuming responsibility for ongoing care as needed
Identifies avoidable hospital days and confers with director regarding findings
Facilitates multidisciplinary communication to maintain ongoing, positive relationships with healthcare team, patients, families, payers/TPA and community providers; functions as a resource to all customers to optimize care coordination and resource utilization Initiates and leads team conferences to achieve consensus regarding continuing care plans
Establishes positive rapport with patients and families; supports decision-making and advocates for patient to ensure advantageous use of benefits
Utilizes knowledge of legal issues, COBRA regulations and regulatory agency requirements; issues notices of non-coverage, important message per CMS guidelines when necessary. Initiates and completes level 1 PASRR screen for all patients going to sniff level of care upon discharge
Makes appropriate referrals to Social Worker
Provides timely and thorough review to insurance companies/TPA
Documents assessments, interventions, patient progress, education, referrals and insurance information in CM progress notes in a timely, accurate manner, as per policy
Ensures the LPN has the information necessary for completion of the nursing process
3-5 years clinical nursing and 2 years hospital case management experience
Working knowledge of InterQual Acute Care guidelines

166

Care Coordinator Chronic Pain Management Resume Examples & Samples

Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health
Masters degree in Mental Health required; education can be in one or more of the following
Ability to analyze specific utilization problems, plan and implement solutions that directly
Minimum 5 years post masters experience with chronic pain expertise and experience required
Masters degree in Mental Health required; education can be in one or more of the following areas: Social Work, Psychology, Nursing or Counseling
Licensure is required for this position, specifically current license as a Masters or Doctoral-level behavioral health practitioner that meets State, Commonwealth or customer-specific requirements. (MD, VA and DC license is required) MD license required for hire, must obtain VA and DC license within 1 month of hire. Licensure may also include one or more of the following: LCSW, LMSW, LCPC, LCADC or LCMFT
Ability to meet Magellan credentialing requirements for independent professional practice (Masters level licensed behavioral health professional)
Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care
Ability to apply Chronic Pain Management Program guidelines
Ability to lead an interdisciplinary care team
Ability to understand and apply coverage guidelines and benefit limitations
Experience and ability to use Motivational Interviewing best practice approach
Familiar with clinical needs and disease processes for chronic pain and co-occurring physical and behavioral illnesses
Knowledge and experience in working with case management and in facilities, with local care coordinators or with special populations
Knowledge of utilization management procedures, mental health and substance abuse community resources and providers
Must possess ability to converse and type at a conversational pace
Strong organization and time management skills with the ability to prioritize and follow through on multiple projects in a timely manner
Understands and adapts appropriately to issues related to communication, cognitive or other barriers
Understands and is able to apply principals of Care Management and Person Centered Service Planning

167

Care Coordinator Resume Examples & Samples

Coordinating care packages and assigning workers to rotas
Ensuring workers have the necessary skills, training and competencies to undertake their shifts
Effectively communicate both verbally and in written form
Arranging care reviews and supervisions
Recruiting new care workers
Ensuring care provision meets CQC guidelines
Demonstrate decision making skills and problem solving
Ability to develop relations with colleagues across the business
Experience in healthcare and social care environment or similar
Commercial in approach and understand factors that influence performance
Have good judgment and decision making skills
Ability to influence and develop relations with colleagues across the business, wider Interserve and commissioners/ customer to deliver relevant goals

168

Care Coordinator NE Resume Examples & Samples

Utilizes assessment skills and risk assessment tools to identify patients with actual or potential care needs that would require care coordination
Assists in managing transitions of care across care settings, ensuring optimal communication and planning
Partners with other care coordinator teams (e.g. primary and transitional care), including Social Work, Rehabilitation, Pharmacy, Palliative Care and others
Educates about managing a specialty condition, including prevention and health maintenance tasks. Provides education and connection to other care providers and community resources to enhance care
Works with practices on quality and process improvement initiatives. Assists in education, auditing quality, data analysis, and workflow processes

169

RN Care Coordinator Resume Examples & Samples

2 + years Experience
RN license Required
Travel: 20%
Nights/Weekends: on occasion

170

Clinical Care Coordinator Resume Examples & Samples

Assess, plan, implement, evaluate and monitor the care of breastfeeding couplets primarily in Von Voigtlander Women?s Hospital (VVWH), but occasionally in Mott Hospital Neonatal and Pediatric Units, Children?s Emergency Services, Adult University Hospital Units and Emergency Services, and the Lactation Consultant Outpatient Clinic(s)
Current licensure as Registered Nurse in the State of Michigan
Ability to achieve certification as a Lactation Consultant through the IBCLC within 6 months

171

Senior LTC Care Coordinator Resume Examples & Samples

Exercises critical thinking to determine direction by independent analysis and use of judgment with minimal oversight and input from manager
Identifies information and resources needed to make benefit eligibility determinations Identifies information and resources needed to make benefit eligibility determinations
Conducts in depth, detailed information gathering phone calls that obtain medical condition details and other information. Represents MetLife at depositions and trials
Identifies and refers appropriate matters to legal counsel
Performs other related duties as assigned or required
BA/BS Degree Preferred
2-3 years of relevant business experience
3-5 years LTC experience preferred

172

Clinical Care Coordinator Resume Examples & Samples

Help to keep members compliant with their care plans
Comprehensive care management
Transitional planning and follow-up
Individual and family support
Referral to relevant community and social support services
Bachelor Degree (or higher) in Social Work, Psychology, Sociology, Life Sciences or Nursing
Must reside in Pierce County, WA or Thurston County, WA area
Must have resided within the local community for 2+ years
Must be able to navigate a Windows PC and utilize Microsoft Office Word, Excel and Outlook
Knowledge of WA Medicaid and Medicare populations
Experience in Counseling or Behavioral Health
Experience working with members of all ages (children to geriatric)

173

Customer Care Coordinator Resume Examples & Samples

Answering customer phone and email enquiries relating to deliveries, invoices, credit and return requests, etc
Monitoring and processing of orders as received by Area Managers and Salons
Be the first point of contact for all salons inquiries
Be the point of contact for area managers in relation to salon orders

174

Choices Care Coordinator Resume Examples & Samples

Assessment – The care coordinator will collect in-depth information about a person’s situation and functioning to identify individual needs in order to identify members at risk with complex clinical and social issues and develop a comprehensive plan of care that will address those needs
Coordination – The care coordinator will organize, integrate, and modify the resources necessary to accomplish the goals established in the plan of care
Evaluation – At appropriate and repeated intervals, the care coordinator will determine the plan of care’s effectiveness in reaching desired outcomes and goals. This process might lead to a modification or change in the plan of care in its entirety or in any of its component parts
Identify members with the potential for high risk complications and coordinate the appropriate treatment in conjunction with the member and care coordination team
Coordinate with institutional facilities as necessary to facilitate access to physical health and/or behavioral health services needed by the member and to help ensure the proper management of the member’s acute and/or chronic physical health or behavioral health conditions
Monitor and ensure that provision of covered physical health, behavioral health, and/or home and community based services are provided as a cost-effective alternative
Develop and implement targeted strategies to improve health, functional, or quality of life outcomes, such as disease management or pharmacy management
Serve as a point of contact for coordination of all physical health, behavioral health, home and community based services and nursing facility services
Coordinate with the Fiscal Employer Agent (FEA) as needed
Maintain appropriate and ongoing communications and collaborations with members, their authorized representatives, physicians and health team members, and payer representatives
Coordinate with member’s primary care provider, specialists, and other providers and care programs to ensure comprehensive, holistic, person-centered approach to care
Minimum of 5 years healthcare w/ 3 years clinical experience required
Ability to work within specified timeframe requirements
100 % day travel required

175

Dsnp Care Coordinator Resume Examples & Samples

Assessment – The care coordinator will assess information about a members’ medical care needs, social situation and functioning to identify individual needs in order to identify members medical needs and develop a plan of care that will address those needs
Planning – The care coordinator will involve the enrollee and other significant parties in the determination of specific objectives, goals, and actions as identified through the assessment process. The care coordinator will use the information to develop a plan specific to the enrollee’s medical needs
Monitoring – The care coordinator will gather sufficient information from all relevant sources in order to determine the effectiveness of the plan of care
Evaluation – At appropriate intervals, the care coordinator will determine the plan of care’s effectiveness in reaching desired outcomes and goals. This process might lead to a modification or change in the plan of care in its entirety or in any of its component parts
2 years experience in Utilization Management, Case Management or Managed Care
Must be PC literate with extensive knowledge of Windows and Microsoft Office
FACETS and Care Advance experience preferred
TB Skin Test (applies to coordinators that work in the field)
Assess resource utilization and cost management; the diagnosis, past and present treatment; prognosis, goals (short- and long-term)
Identify opportunities for intervention
Arrange, negotiate fees for, and monitor appropriate cases and services for the client
Maintain communication and collaborate with patient, family, physicians and health team members, ICT participants and payer representatives
Compare the client’s disease course to established pathways to determine variances and then intervene as indicated
Establish measurable goals that promote evaluation of the cost and quality outcomes of the care provider

176

Care Coordinator My Care Alabama Resume Examples & Samples

Assessment – The case manager will collect in-depth information about a person’s situation and functioning to identify individual needs in order to identify members at risk for high cost medical care and develop a comprehensive case management plan that will address those needs
Implementation – The case manager will execute specific intervention that will lead to accomplishing the goals established in the case management plan
Monitoring– The case manager will gather sufficient information from all relevant sources in order to determine the effectiveness of the case management plan
Evaluation – At appropriate and repeated intervals, the case manager will determine the plan’s effectiveness in reaching desired outcomes and goals. This process might lead to a modification or change in the case management plan in its entirety or in any of its component parts
As a client advocate, seek authorization for case management from the recipient of services (or designee)
Routinely assess client’s status and progress; if progress is static or regressive, determine reason and proactively encourage appropriate adjustments in the care plan, providers and/or services to promote better outcomes
Conduct case screenings using applicable tools to determine appropriate levels needed to meet member needs
Certified Case Manager (CCM®) credential preferred; required to take examination when eligible. Case Managers must obtain a CCM certification within 2 years of hire as a case manager or they will no longer be able to perform case management functions

177

Pcmh Care Coordinator Resume Examples & Samples

Provide telephonic outreach and in-person consultation to members identified as high risk, having a chronic condition(s) and in need of preventive services
Prefer 3 years’ experience providing care coordination to persons receiving medical treatment with chronic conditions, Case Management or Care/Disease Management
Proficient with processes to build teams and participate in cross-functional teams
Position requires 12 months in role before eligible to post for other internal positions
Experience with Motivational Interviewing Techniques and Adult Learning Styles
Exceptional interpersonal communication skills are required

178

Patient Navigator, / Care Coordinator Resume Examples & Samples

Associate's degree (or equivalent combination of formal education and experience in community health) plus a minimum of 1 - 2 years in healthcare is required.A Bachelor of Science in Public Health, Biology, Psychology, Education, Social Work or an equivalent degree preferred. May waive experience requirement for candidates with Bachelor's degree or higher
Knowledge of health care systems and community resources available
Proficiency with standard software programs used in healthcare (such as MS Word, Excel, Outlook) and web browsers, patient registration systems and electronic medical record
Ability to multi-task and work under time pressures
Ability to communicate well both verbally and in writing with other members of the clinical team
Excellent English communication skills. Additional language skills appropriate to the patient population served (especially Spanish and/or Creole) is desirable
Self directed and independent
Must be a self-starter and possess excellent customer service skills

179

Clinical Care Coordinator LPN Resume Examples & Samples

BLS certification within first six months of employment
Basic typing and filing skills required. Familiarity with computers and work processing programs. Able to complete data entry and retrieve patient information from an electronic patient file
Articulates and demonstrates commitment to the philosophy, values, mission and vision of Mercy Health Partners
Ability to interact with various individuals with diverse backgrounds
Demonstrate a customer service orientation with patients and family members
Good interpersonal communication skills and ability to work effectively as a team member

180

Clinical Care Coordinator Resume Examples & Samples

Licensed Practical Nurse or Registered Nurse
Minimum of three years' experience directly related to clinical work in a physician office
Well-developed communication skills, both written and verbal. Able to communicate effectively with individuals and groups representing diverse perspectives
Actively support the mission of MHP. Demonstrate support for Value Based Principles of Operation through performance of duties

181

RN Care Coordinator Resume Examples & Samples

Licensed as a Registered Nurse in the State of Florida
Bachelor’s degree in Nursing (BSN) or Associate’s degree in Nursing (ASN) with Bachelor’s
Degree in a closely related field preferred
3 years nursing experience prior to care coordination required; at least 5 years preferred
Ability to exercise good judgment and tact in relating to third-party payers, physicians and
Patients
Ability to establish and maintain effective and cooperative working relationships with
Hospital staff and others contacted in the course of this position
Demonstrated ability to effectively prioritize multiple tasks and deadlines; work
Independently
Demonstrated ability to effectively present information and respond to questions from small
Groups or on a one-on-one basis
Demonstrated ability to deal with problems involving several concrete variables in
Standardized situations

182

Continuous Care Coordinator Resume Examples & Samples

Two years prior work experience. One year staffing experience preferred
Typing skills, computer literate, and excellent communications and phone skills
Nursing knowledge
Able to handle multiple tasks
Organized and a team player

183

Services Care Coordinator Outpatient Resume Examples & Samples

Assist callers by providing benefit and eligibility information and referrals to network providers
Verify member benefits and eligibility through health plan computer access, phone and e-mail
Educate callers about Beacon/BCBHM services and their mental health benefits
Obtain urgent, routine assistance with appointments within established time frame guidelines
2-3 years’ experience in an administrative support, customer service or similar position
Helathcare Scheduling experience

184

Care Coordinator Resume Examples & Samples

Assist members and providers with all levels of inquiries, problem solving, insurance information and general customer service, which could include
Staff all Call Center queues and adhere to performance requirements for call center response times, abandonment rates, and other productivity, schedule, and quality standards or metrics that may be established
Monitor the data in the clinical care management system, collaborating with provider community; escalate issues and concerns regarding care management to Senior Care Managers according to policies and procedures
Analyze data and identify appropriate level of care to expedite linkage to care to ABA services
Gather required clinical and financial information care for members and enter data into clinical care management system

185

Care Coordinator Resume Examples & Samples

Contact Ateb’s pharmacy clients’ patient population to solicit enrollment to Ateb’s Patient-Centric Solutions and Services
Provide ongoing support services to the clients using Patient Centric Products and Services
Training new customers and existing clients on new products and services
Identify and present opportunities for improvement in processes and performance
Ability to quickly achieve a working knowledge of Ateb’s Patient-Centric Solutions and Services
High level of organizational skills
Desire to effectively interact with clients and internal Ateb team members
2+ years retail pharmacy technician experience desired
Pharmacy technician certification
Exposure to or knowledge of pharmacy business processes and operations is desired
2+ years of college education
Entry level call center experience

186

Consumer Customer Care Coordinator Resume Examples & Samples

Collect pre-move surveys as well as weights and preapprovals and update company software and the carrier
Track shipments’ estimated time of arrival and delivery information and update company software and the carrier
Monitor clearing email to clear shipments as they arrive and provide main point of contact for moves, both internally and externally

187

Care Coordinator Resume Examples & Samples

Perform comprehensive clinical and diagnostic assessments for members meeting institutional level of care
Bachelors degree in Social Work
Minimum of two (2) years of case management experience in inpatient or outpatient medical care, long-term care, managed care, home health care, behavioral health settings
Masters degree in Social Work
Minimum of two (2) years of experience in waiver or long term support services settings

188

Care Coordinator Resume Examples & Samples

Utilizes clinical care guidelines to provide expert care to patients with chronic diseases by covering all five domains of the patient including social/behavioral health, chronic, acute, preventative, and special care needs
Conducts intake interviews using standardized assessment tools and monitors progress of patients
Provides feedback and outcome measure reports to clinicians
Provides support and assessment of treatment compliance and provides crisis intervention as necessary to patients between visits, and provides timely care as patient transitions from one setting to another
Uses health coaching strategies to develop, implement, and evaluate self-management strategies for patients as well as learning programs for patients and their families
Acts as a liaison and provides consultation to clinicians within the JHN regarding the care of patients with chronic conditions while supporting and participating in the practice’s model of care as a Patient Centered Medical Home
Serves as a resource for staff by sharing skills and knowledge related to area of expertise
Participates in continuous quality improvement process via team involvement and by supporting changes recommended through the continuous quality improvement process
Works effectively in collaboration with multiple disciplines and community facilities/resources to provide innovative and evidence-based care while achieving high quality outcomes in a cost-efficient manner
Identifies and connects patients to community-based resources that will help to facilitate care
Completes necessary documentation in the EHR and other applied care management software/databases
Assists with the creation and support of Evidence-Based Medicine education with participation and collaboration with community stakeholders at committee meetings
Works primarily with a high risk population identified through PCP referral, risk stratification and patient lists
Duties may include focusing on patients not considered high-risk
Demonstrates ability to work effectively in a dynamic and rapidly changing environment
Demonstrates leadership qualities and the ability to function independently
Discharge planning experience required
Must have previously completed or does not complete motivational interviewing training within six months of hire
Full License to practice as a Registered Nurse in the State of Michigan
Working knowledge/experience in utilization management, managed care, and payer issues is required
Supports JHN’s mission and goal is required
Exceptional computer and analytical skills – to be used in all aspects of care
Demonstrates leadership ability, clear communication and interpersonal/customer service skills necessary to interact effectively with physicians, management, staff, external agencies/customers and patients/families is required
Knowledge of care of neonate, pediatric, adolescent, adult, and geriatric patients is required
Establish priorities and coordinate work activities among multiple requests

189

Care Coordinator Resume Examples & Samples

Utilizes social work principles to provide expert care to patients with chronic diseases by covering all five domains of the patient including social/behavioral health, chronic, acute, preventative, and special care needs
Conducts intake interviews and monitors progress of patients
Provides support and assessment of treatment compliance and provides crisis intervention as necessary to patients between visits
Participates in continuous quality improvement via team involvement and by supporting changes recommended through the continuous quality improvement process
Completes necessary documentation in the EHR and other care management software/databases
Full License to practice as a Medical Social Worker in the State of Michigan
Working knowledge/experience in utilization management, managed care, and payer issues
Support of JHN’s mission and goals
Exceptional computer and analytical skills used in all aspects of care
Demonstrates leadership ability, clear communication and interpersonal/customer service skills necessary to interact effectively with physicians, management, staff, external agencies/customers and patients/families
Knowledge of care of neonate, pediatric, adolescent, adult, and geriatric patients
Ability to establish priorities and coordinate work activities among multiple requests

190

Care Coordinator Resume Examples & Samples

Support the member to ensure pick-up of their Rx or sign them up for mail delivery of their prescriptions
Partner with care team (community, providers, internal staff)
May conduct Health Risk Assessments via phone or in person, if needed
Provides clinical and medical management services, including case management, health assessments, interventions, and discharge planning
Bachelor Degree (or higher) in healthcare related field (Healthcare Administration, Nursing, Social Work, Psychology, etc.) or High School Diploma and a current LPN
3+ years clinical experience in a hospital, acute care, home health/ hospice, direct care or case management
Computer/ typing proficiency to enter/retrieve data in electronic clinical records
Experience with email, internet research, use of online calendars and other software applications
Ability to travel up to 75% of the time, locally
Home care/ field based case management
Medicaid, Medicare, or Managed Care experience

191

Care Coordinator Exceptional Needs Resume Examples & Samples

Identify appropriate Medicaid and Charitable members for enrollment screening using case finding methods: Likelihood of Hospitalization score, care gap scores, over/under use of ED/UC, appointment cancellations and no-shows, medication non-compliance and the dx codes for children and direct referrals from agency case managers, primary care providers, or other sources
Independently and proactively complete chart reviews, screening calls and full assessments related to the anticipated level of care and document findings using approved documentation tools
Triage findings from member assessments, identifying needs and issues and plan appropriate interventions. Determine Level of Care. Communicate findings and actions to involved care providers through succinct summaries that include findings, actions and further recommendations
With the member/family and appropriate KP staff and providers, develop a care plan that addresses short term goals that are specific, attainable and measurable and work with PCP to ensure a clear medical treatment plan is documented
Provide care coordination and management services for members with identified needs within the scope of the ENCC/SNCC role by: Creatively using available and appropriate resources, including KP staff and providers, to support the unique needs of each member with special needs; Facilitating access to internal and external services; Monitoring the effectiveness of the interventions; and Reinforcing the treatment plan through medication compliance including support for Opiate Therapy Plan compliance; and Advising and coaching patients and families; Identify non-medical issues; environment, abuse and neglect, homelessness and hunger and other safety concerns and work with state agencies and KP providers to support and remedy where possible. Provide care management and oversight to members participating in the Patient Review and Coordination Program for WA Medicaid. Succinctly document interventions in HealthConnect as needed by other providers to ensure coordination of care and services. Add relevant intervention details to the Special Populations Registry
Strengthen and update the ENCC/SNCC program through: Education of staff/clinicians about ENCC/SNCC and the special needs of our low income population. Development and distribution of education, tools and materials for member coordination. Completion of an annual program review including related policies, desk procedures, and documentation tools
Act as a liaison between KP, other HMOs, and county and state organizations. Actively participates in Kaiser Permanente committees and workgroups and in county/state committee and functions
Minimum two (2) years of direct patient care as a registered nurse
Prior experience serving the mentally ill and or individuals with substance abuse issues
Prior experienced as a care coordinator or discharge planner. Knowledge of the Kaiser Permanente system, including HealthConnect
Knowledge of Medicaid/Medicare programs and regulations
Knowledge of quality management and utilization management principles
Professional certification as a case manager

192

ASD & Dev Dis Care Coordinator Resume Examples & Samples

Review clinical progress notes prepared by outside clinical vendors and sets goals in conjunction with outside vendors based upon appropriate professional experience and licensure, for the ASD and developmental delayed population
Make clinical determination regarding appropriateness of therapeutic goals and need for ongoing therapeutic intervention by outside vendors, for the ASD and developmental delayed population
Serve as a resource and liaison between the member and the outside vendors once initial services have been authorized at the local level, for the ASD and developmental delayed population
Serve as a resource and liaison between the outside vendors who are providing direct patient care for the member and KP once initial services have been authorized at the local level, for the ASD and developmental delayed population
Document as appropriate and necessary in the medical record/Health Connect, for the ASD and developmental delayed population
Regional coordination of the therapists (Speech, Occupational Therapy and Physical therapy) in the dissemination of updates and facilitating exchange of information etc, for the ASD and developmental delayed population
Communicate and maintain professional relationships with other integrated departments (e.g. Outside Referrals, Regional Utilization Management, Affiliated Provider Services etc) Maintain contact with the ASD teams in the local areas
Minimum six (6) years of working as a fully licensed Speech/Language Pathologist, with a minimum three (3) years of working with the Pediatric population

193

Certified Clinical Care Coordinator Resume Examples & Samples

Certified through a nationally recognized Medical Assistant program such as American Association of Medical Assistants (AAMA), American Medical Technologists (AMT), Registered Medical Assistant (RMA) or National Center for Competency Testing (NCCT)
Current certification American Heart Association Basic Life Support (AHA-BLS) for the Healthcare Provider
3 - 4 years of healthcare experience working as a medical assistant
College
Strong preference to be bilingual in Spanish

194

Care Coordinator Resume Examples & Samples

Address complex clinical and social situations efficiently in order to avoid unnecessary delays in discharge
Attend Department meetings and Corporate Care Management Training sessions in order to maintain current knowledge of all payer and regulatory requirements, UPMC CM policies and procedures, community resources
Collaborate with patients, caregivers, internal/external healthcare providers, agencies and payers to plan and execute a safe discharge
Develop alternative/multiple discharge plans in anticipation of patient need for post-acute services
Document all Avoidable Days in CANOPY system
Ensure compliance with all payer and government regulations
Follow payer-specific requirements to obtain and document authorizations
Initiate acceptance of lower LOC when appropriate with assistance from billing office
Obtain Consent to Appeal on Behalf of Member on all cases with concurrent denial
Obtain all necessary authorizations for level of care including admission and continued stay
Perform clinical review on admission and/or continued stay using InterQual criteria to determine appropriate level of care (Inpatient, OBS, etc.)
Proactively identify barriers to discharge and work with multi-disciplinary team to expedite care, monitor length of stay (LOS) and facilitate discharge
Promote patient safety. Support CORE measures information for JCAHO requirements
Re-evaluate and revise discharge plan as patient clinical condition merits
Review medical record daily to ensure patient continues to meet LOC requirements and that chart documentation supports LOC determination
Serve as resource to clinical and finance teams for clinical documentation requirements, level of care, insurance coverage issues, specific payer and government policies and post-acute services coverage and availability
Start discharge planning on admission and ensure DC documentation is completed and updated regularly
Take leadership role in concurrent denial process
Use InterQual criteria to justify appropriate LOC (Skilled, Rehab, Home Care, DME, etc.) and obtain all necessary payer authorizations for post-acute care
Work with Care Management Director, Physician Advisor, Attending Physicians and clinical team to obtain necessary information and documentation to support LOC
Work with Physician Advisor and Attending Physicians to obtain necessary documentation to support current LOC, alters LOC as needed and expedite discharge planning for patients who no longer require hospital services

195

Care Coordinator of Transplant Services Resume Examples & Samples

Support the development, deployment, and outcomes of transplant support services
Work with internal and external healthcare providers to deliver service excellence
Manage data to identify challenges and guide decision making
Work with IT systems effectively
Report to corporate team on program progress, identify gaps and provide feedback and recommendations, helping to shape the program as it grows
A “community first, company second” culture based on Core Values that really matter
Bachelor’s degree or relevant work experience
Relevant experience in healthcare
Proficiency in Excel and other Microsoft products
Strong relationship-building skills; track record of successful relationship development and ability to quickly build credibility and gain the confidence of individuals and teams
Understanding of healthcare markets and integrated care
Team player with the ability to sell change effectively and influence others

196

Care Coordinator Resume Examples & Samples

An Associate's Degree in a related field is preferred
3+ years of experience in a managed care setting, medical office or facility setting with demonstration of medical administration duties is required
Required Intermediate Microsoft Outlook Proficient in Microsoft Office such as MS Outlook, MS Word and MS Excel is required *LI-RG

197

Customer Care Coordinator Resume Examples & Samples

Able to travel for short periods of time, intrastate/interstate/overseas
Excellent organizational, prioritization and multi-tasking skills
Computer literacy (SAP/JDE, Microsoft Office, Gmail and Google docs)
Flexible with work hours – there will be a requirement to cover different time zones
Ability to adapt to change and handle change easily
A team player with a friendly disposition and high energy
Exceptional written and verbal communication skills, with the ability to build relationships by phone & email
Calm & rational thinker able to work under pressure to strict timelines
Able to manage internal/ external customers who are under stress
Willingness to learn and high attention to detail
Self-motivated, ability to take on additional responsibilities as required and work with minimal supervision
Desire to challenge current processes for improvement
Strong analytical skills, adept at problem solving and managing escalations

198

Managed Care Coordinator Resume Examples & Samples

Responsible for managing and scheduling all outside referrals to the clinic
Maintain referral log, distribution of referral packets and scheduling
Serve as back up to the insurance verification coordinator
Counsel patients on insurance benefits when needed
Educate PSS, nurses and providers on insurance benefits and funding for referred patients
Assist with worker's compensation referrals and authorizations as needed
Assist with testing and surgery authorizations as needed
Proactively assist others as needed
Experience in a medical office setting with insurance verification, authorizations and referrals
Experience in a medical office setting working with patient scheduling, phone triage and payment collections
Ability to communicate effectively with staff, physicians, other billing team members and patients
Ability to work in a busy environment
Proficient at Microsoft Office

199

LVN Care Coordinator for Wellmed Resume Examples & Samples

Coordinates follow-up care appointments and/or assists in directing care to physician clinic nurse or ITC clinic and/or medical services for post-hospitalized patients and assures timely and complete communication to ITC clinics when applicable
Assesses patients’ clinical information and effectiveness of current medical services through phone interview, following either the WellMed or Milliman specified template for the type of call being made
Provides health services counseling regarding identified patient knowledge deficits, such as dietary information, medication orders explanation, and rationale for immediate follow up with primary care physician/ITC, etc
Identifies need for non-covered services and provides options for the patient with the assistance of WellMed case manager(s) and/or social worker(s)
Identifies urgent issues and forwards to the case manager, case manager supervisor, case management manager, or PCP as indicated
Makes follow-up calls to member as necessary to resolve items identified on initial call
Notifies case manager if information is obtained indicating the member is using a non-participating or non-authorized provider to allow case manager to investigate and pursue either an LOA for services or to redirect services in plan, or that patient has been institutionalized
Provides PCP with outpatient care assessment information and documents follow-up and interventions in the Case Management Documentation System (CMDS)
Current LVN license (specific to state of employment)
Previous experience in physician’s office as LVN in back office or hospital floor nurse of medical/surgical bed
Knowledge of legal ethical issues related to patients’ rights, rehabilitation terminology, discharge guidelines, community support services and funding

200

Regional Care Coordinator Resume Examples & Samples

Identify patient and family needs across medical, behavioral, psychosocial, and educational domains
Support adherence to plan of care and assess accomplishment of goals set in the care plan
Facilitate all care transitions across primary care, inpatient, specialists and community settings
Contact agencies, supply companies, insurance providers and all medically related providers
Work closely with outside agencies to maximize the best possible scenario for a medically complex pt
Provides LOMN, POC, Prior auth, and all forms needed to provide the best available care
Reviews emergency and acute admission discharge summaries for patterns of care that can be impacted by better care planning and coordination

201

SW Field Care Coordinator, Kansas City Metro Resume Examples & Samples

Provides options and choices for long term care community or facility-based service delivery
Develops member goals of care and interventions for unmet needs in coordination with the member
Facilitates appropriate member referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, Advanced Illness, Complex Case Management
2+ years clinical or case management experience in long-term care, home health, hospice, public health or assisted living (post graduate experience)
Experience in Home & Community based or Long Term Care services delivery or Waiver Program

202

Trusted Care Coordinator Resume Examples & Samples

Collaborate with client leads and a project management team and subcontractor to coordinate logistics for safety and reliability implementation site visits, data collection, and online trainings at military healthcare facilities within a geographically dispersed region
Complete safety and reliability trainer training and deliver onsite training
Provide regular project status briefings, including reporting on past and planned activities, identified risks, and mitigation plans
Serve as the primary client contact in the field and anticipate and identify client issues and concerns
Maintain awareness of broader project progress and goals, communicate updates regularly, and disseminate project resources and materials to client leads
Collect and analyze data on the success of safety and reliability implementation within a region and report results to client leads and a project management team
3+ years of experience with healthcare program management and administration
Experience with the military
Applicants selected will be subject to a security investigation and may need to meet eligibility requirements for access to classified information

203

RN Care Coordinator Resume Examples & Samples

Ability to work with diverse populations
Ability to be sensitive to cultural, economic, gender, and sexual orientation differences
Excellent writing and critical thinking skills is required
Proficient in Microsoft Office, Excel, PowerPoint and essential office computer applications
Background in public health and population health management, ideally experience with DHS and/or affiliated DHS agencies preferred
Knowledge and experience in working with the healthcare system as a health advocate preferred
Experience in behavioral health is preferred
Prior work experience suitable for the position is preferred
Oversight of Medical Assistants and Community Health Workers/Health Navigators
Current Pennsylvania Registered Nurse licensure

204

Care Coordinator Resume Examples & Samples

*THERE ARE MULTIPLE OPENINGS ASSOCIATED WITH THIS POSTING***
Registered Nurse (RN) with current, valid, unrestricted clinical license to practice in state of operations
3 years clinical practice experience
Experience utilizing various software packages
Analytical skills

205

High Risk Program Care Coordinator Resume Examples & Samples

Previous Primary Care office experience front and back office experience
Previous experience working in community with health education for vulnerable populations, understanding of social factors that contribute to need for help with health system navigation for wellness
Excellent communication skills both verbally and in writing
Knowledge in MS, Excel, Powerpoint and Access
Demonstrated ability to coordinate and research the review of difficult, complex Utilization Management issues
Knowledge of third party payors
Electronic Medical Record/EPIC experience

206

Clinical Care Coordinator Resume Examples & Samples

Experience in working in a healthcare setting
Fluency in oral and written communications in English
Demonstrate superb interpersonal skills to successfully interact with variety of people, including high-level executives, civic leaders, and members of the community from diverse cultures and backgrounds
Ability to maintain strict confidentiality (in interactions with both internal and external people) concerning work-related information
Knowledge of patient scheduling and authorization
Ability to interact well with all patients
Demonstrated knowledge and advanced level skill in work processing software applications (Word, Excel & PowerPoint)

207

Clinical Care Coordinator, Cancer Center Resume Examples & Samples

Experience in working in a large, complex healthcare setting
Experience in working with Health Insurance companies and Community Medical Groups
Excellent ability to communicate in English both orally and in writing
Knowledge of surgery scheduling and authorization
Ability to interact well with care teams, and all patients and families
Two to three (2-3) years’ experience in a similar role of providing high level clinical administrative support
Prior Oncology experience
Experience with EPIC EHR system (incl. Cadence)
Knowledge in medical/scientific terminology, Hematology/Surgical Oncology terminology, authorizations, various insurance products & 3rd party payors
Bilingual: Spanish/English

208

Clinical Care Coordinator Resume Examples & Samples

Communicates pertinent information to patients, family, staff
Participates in activities for professional development and maintains required clinical knowledge, technical skills, training, and credentials
Plans, initiates and coordinates care and education for patient / family and staff

209

International Care Coordinator Resume Examples & Samples

Working to develop, manage and sustain strong relationships with a target customer base, which includes international patients, physicians and various referral sources, and oversee the management of patient referrals are primarily responsibility of this position
Ensuring all appropriate appointments, treatment, medications, durable medical equipment and general care, recommended by the treating clinical team, are in place, and verifying financial viability of self-pay, insurance and embassy patients
This position also requires the ability to manage clinical, educational, and instructional documentation in various languages
Requires a highly engaged, self-motivated independent thinker and exemplifies service excellence in all encounters
Bachelor’s degree required. Preferred fields of study are healthcare or international
Minimum of 3 years’ experience in a setting that involved significant interaction with patients and/or clients, customer service required. Translating/interpretation preferred
Proficiency in oral and written English required. Foreign language(s) proficiency preferred (Arabic, Spanish)
Knowledge of international cultural standards and customs preferred
Familiarity of global healthcare systems (EMEA, MENA, LATAM) preferred
Knowledge of general hospital policies and procedures, including diagnostic and therapeutic procedures preferred
Knowledge of medical terminology and anatomy preferred
Proficiency in database management preferred

210

Care Coordinator Resume Examples & Samples

2 years' of case management/care coordination experience in an inpatient, HMO, insurance, or other outpatient setting
Master's Degree in healthcare related field
3 to 5 years of health care experience in an acute care setting

211

Clinical Care Coordinator Resume Examples & Samples

Extensive knowledge about urology care and chronic care management is a critical skill for this position
Provides coordination of care across care continuum for patients and families in the Department of Urology
Coordinates care pre-operatively and post-operatively for these patient populations including, but not limited to, patient teaching, counseling and obtaining informed consent forms for a variety of urologic surgical procedures
Provides tele-health nursing to patients and families to include: triaging calls from patients and families, clinicians, and other healthcare team members
Assist in clinic with minor and complex procedures
May perform uro-dynamic testing
Serves as a clinical expert to peer groups, medical staff, and other interdisciplinary groups through formal and informal consultations and presentations
Collaborate with other health team members and associated resource persons to ensure continuity of care across all care environments
Assist in the development and implementation of competencies, protocols, and patient education tools to improve patient care
Participate and assist with ongoing research
Participation in Adult Urology clinic team meetings to continually improve clinic processes
Candidate must possess high level critical thinking skills and clinical judgment to care for patients with complex urologic conditions
Candidate must be able to function with a minimum of supervision and be highly motivated to provide excellent care and patient advocacy
Assists in the development of patient care standards in collaboration with clinical management teams
Recent ambulatory care experience (within last two years) in an adult surgical setting
Minimum 2 years RN experience (within the past 4 years) caring for adult urology patients
Experience performing uro-dynamic testing

212

Certified Clinical Care Coordinator Resume Examples & Samples

Completion of an accredited Medical Assistant program and certified through a nationally recognized Medical Assistant program such as American Association of Medical Assistants (AAMA), American Medical Technologists (AMT), Registered Medical Assistant (RMA) or National Center for Competency Testing (NCCT)
3 to 4 years recent healthcare experience working as a Medical Assistant
Current AHA-BLS (Basic Life Support) for the Healthcare Provider

213

Care Coordinator Resume Examples & Samples

Knowledge of Case Management process
Excellent organizational and professional communication skills
Knowledgeable in utilizing screening criteria in review of clinical data with respect to patients/clients needs for health care
Ability to effect change performs critical analysis, promote client/family autonomy and plan and organize effectively for the continuum of care

214

Managed Care Coordinator Resume Examples & Samples

Supports Managed Care Management Team as directed by VP
Maintains attendee listing and schedules recurring joint operations meetings with Managed Care Payers
Supports Vice President of Managed Care, including but not limited to managing calendar/scheduling and meeting preparation
Completes other administrative duties as assigned by the VP, which may include but is not limited to: Maintaining office supplies, Completing expense and check requisitions, answering department phone calls, and scheduling/coordination/participation in meetings
Creates Power Point presentations and various reports when requested
Assist with mailings and various other communication activities
Coordinate/manage the Managed Care Contract storage, documentation & retention process
Support Managed Care Systems implementations and maintenance, as required
Prepares meeting documents, agendas, and/or takes minutes for meetings
Proof reads external communications
Manages Payer Facility Credentialing Process
Monitor Payer Websites & Communications and communicates impactful changes/updates to Managed Care Management Team
Processes access requests and updates content for Departmental Intranet Site Content
Attends/participates in educational/professional development opportunities as assigned
Maintains departmental Policies & Procedures documents and works with Managed Care Management Team regarding any updates, as needed
Assist department with other duties as assigned
Proficiency in MS Word, MS Excel and MS Outlook a must
Knowledge of operating standard office equipment
Excellent communication skills – written and verbal
Ability to prioritize projects and strong problem solving skills
Good research skills and attention to detail
Ability to participate in creating an environment that implements the mission, vision and values of the organization
Encourage collegiality when integrating valve services with other departments
Must be able to establish priorities and a course of action for managing several activities at once while observing deadlines, and to function and communicate effectively with multidisciplinary team members
Demonstrated high level of motivation to learn and participate in activities to improve patients care
Skilled in programs such as Word, Excel, Power Point, and Access
Demonstrates good verbal, and written communication skills

215

Care Coordinator Resume Examples & Samples

Assesses the high risk member’s current medical circumstances, provides information about health care options, serves as guide and advisor to the patient and his/her family, and establishes and molds the relationship with the primary care physician and the patient. Through risk stratification, high risk members will be identified, and a case opened for members who meet criteria for care coordination services
Care Coordinator will measure case performance based on program goals, objectives, quality indicators, and patient specific outcomes
Researches and selects care options as appropriate. The nurse care coordinator may utilize a range of alternative, non-medical services (i.e., diabetic education, cardiac rehabilitation and dietary instruction) and treatments. The care coordinator may also make recommendations for alternative medical care for approval by the primary care physician
Assists health plan members and their families in selecting care options by providing information about providers, services and treatments, risks and potential results involved with options
Maintains a comprehensive, computerized medical and social history for assigned patients. Information will be used for such activities as patient assessment, care planning, patient/care evaluation, case tracking, and risk prediction, as well as cost analyses. Software system will be utilized to enhance communications among the health care team
Makes recommendations for systems development from a user’s perspective
Participates in company quality service initiatives
Creates meaningful reports that establish the value of care coordination
BS preferred; Active Professional Licensed RN required. CCM certification or working toward
Minimum 5 years clinical experience (medical/surgical, community health nursing, home health care) and/or 3 years case management and/or UR experience preferred
Regularly handles multiple patient cases involving a variety of providers, situations, deadlines, and multiple priorities
Uses a computer on a continuous basis to maintain patient information and to conduct analyses. Uses other general office equipment (fax, copier, and phones) requiring flexibility and some strength for general maintenance activity
On a daily basis, reads and review handwritten or typed medical records and prepares and develops additional data and notes for use by medical personnel

216

RN Care Coordinator Resume Examples & Samples

Facilitates efficient care for targeted Erickson Advantage health plan members in a variety of settings, focusing on returning the member to the safest and highest level of independence possible. The Care Coordinator utilizes a variety of interventions and coordinates care for targeted health plan members with a variety of providers, in a variety of care settings
Works closely with members who have multiple or poorly managed chronic disease/s. as defined target diagnoses in the health plan Policies and Procedures
Works with the primary care physician to establish protocols for routine and preventive care which reflect accepted standards of care. Facilitates development of customized care plan through collaboration between the, primary care physician, the health plan member, and other health care team providers including specialists, vendors, and ancillary healthcare providers. As a member of the care delivery team, works to facilitate health plan member compliance and ensure continuity of care per the team’s “care plan”
Reassesses the effectiveness, quality of services, and treatments provided, per health plan Policies and Procedures. Adjusts the plan of care to reflect problems, interventions, goals, and outcomes
Establishes a network of community resources necessary for providing appropriate care to patients
Serves as health plan advocate by conducting training sessions, offering presentations, visiting providers, etc
Maintains a focus on timely customer service

217

Point of Care Coordinator, Laboratory Resume Examples & Samples

Provides technical oversight of all hospital and applicable offsite Point of Care testing
Performs clinical lab procedures following established guidelines
Ensures compliance with regulations of all existing applicable state, federal and regulatory agencies
Implements and monitors proficiency testing and quality assurance programs
Develops and maintains technical policies and procedures
Maintains acceptable quality, safety and service levels for the point of care program
Maintains complete and accurate documentation
Resolves technical and customer service problems
Educates and trains testing personnel, ensures competency
Performs projects/additional tasks and other duties as assigned

218

RN Care Coordinator Resume Examples & Samples

Coordinates appropriate laboratory and diagnostic testing
Assesses the healthcare, educational and psychosocial needs of the patients and family
Reviews the current literature regarding effective engagement and communication strategies, care management strategies and behavior change strategies and incorporates into clinical practice
Adheres standards regarding member confidentiality
Performs duties that may be in an embedded or remote environment
Performs duties as required or assigned by emergency or other operational reasons for which the employee is qualified to perform
Demonstrates customer focused interpersonal skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, patients, and families with diverse opinions, values, and religious and cultural ideals
Reveals ability to work autonomously and be directly accountable for results
Incorporates excellent written, verbal, and listening communication skills, positive relationship building skills, and critical analysis skills into care management practice
Possess the skill to function effectively in a fluid, dynamic, and rapidly changing environment
Displays the proven ability to positively influence behavior and outcomes
Protects confidentiality of data and intellectual property; insures compliance with national health information projection guidelines
Demonstrates flexibility and ability to adapt to evolving requirements of DSRIP program

219

Care Coordinator Resume Examples & Samples

Background, exposure, or interest in dermatology, plastic surgery or esthetic fields,
Superior customer service with a concierge hospitality and business sales focus,
Comfort level with consultative conversations including providing medical education, and financial costs of non-covered services for optimal patient empowered decision making,
Demonstrated self-motivation and innovation to identify and partner with surgeon to advance and grow practice,
Flexibility and adaptability to transition effectively between medically complex care and cosmetic care environments
Effective organization for administrative oversight including medical supply management for cosmetic practice and comprehensive clinical and non-clinical documentation
Effective ability to work with team of RNCCs to support departments needs
3+ years of experience as an RN

220

Cardiovascular Services Care Coordinator Resume Examples & Samples

Establishes and monitors standards of nursing care in cardiovascular by working with staff, nurses, committees, and task forces
Evaluates quality of nursing care by making rounds, collecting, analyzing, and trending quality indicator data, and direct observation of nursing care. Identifies problem areas, provides staff coaching, make recommendations for other solutions
Responsible for developing, reviewing, and revising policies and procedures and order sets related to the care of cardiovascular patients
Follows cardiovascular patients from Pre-Admission, to Post Discharge and coordinates care, provides patient/family education, and collaborates with nursing staff and other providers to identify patient needs, develop plans of care, and evaluate patient/family progress towards goals
Provides patient education to patients and coordinates the development, revision, and implementation of patient education programs, materials, and resources in specialty area
Identifies education needs of staff in cardiovascular surgery and critical care areas and plans, implements, and evaluates formal educational programs to meet staff needs. Develops, coordinates, and teaches workshops and classes in area of expertise. Studies change in specialty area and seeks additional knowledge on unusual problems and conditions, new treatments, and medications
Demonstrates quality nursing care, problem-solving skills, effective uses of resources, collaboration with other health care professionals, and professional standards. Plans and implements interdepartmental and inter-agency cooperation to provide for continuity of patient care
Represents the clinical division by making presentations and participating in forums, committees, and professional associations
Acts as a preceptor to nursing and other student
Minimum of 5 years of experience with cardiac and vascular surgery critical care
Skills in physical assessment, lab data interpretation, technological skills and nursing theory and practice required
Teaching experience in patient/family and staff education required

221

RN Care Coordinator Resume Examples & Samples

Performs comprehensive assessment of patients’ health needs, including health status and behaviors, level of function, psychosocial situation, and available support systems and determines potential needs
Establishes care plans in collaboration with the primary care physician and the patient care team
Provides health education
Identifies patients at risk for proactive intervention
Ability to pull and manipulate data to identify risk patients and present information to the care team
Refers patients to a variety of resources including, but not limited to, nutrition, social work, rehabilitation, behavioral specialist, diabetes education, Healthy Living Workshop, etc
Contacts patients who utilize ED or have been hospitalized within 24 hours of discharge to determine the reason for the ED visit or hospitalization and works with patient to develop a plan to avoid those facilities
Coordinates care for complex cases or those patients seeing multiple specialists
Maintains up-to-date and accurate documentation of patient assessment and plan provided to the patient to ensure the effective integration of information for use by the health care team to ensure on-going and continued quality of care, in accordance with evidence-based practice, MT Board of Nursing and SVPN policies and regulations
Analyzes patient care trends and actively seeks out and collaborates with the care team to improve overall quality and efficiency of care
Uses registry data to identify problems or gaps in services and initiates intervention
Demonstrates critical thinking for problem solving and prioritization
Actively participates and leads patient care conferences
Manages patient panel with physician office staff to identify appropriate patients and measure outcomes
Collaborates with physicians and office staff
Pro-actively advocates for patient care issues to ensure that overall quality and type of care is sensitive to each specific patient/family’s needs
Collaborates with payors and outside agencies to promote a patient centered delivery concept
Participates in committees and activities related to the development of Medical Home; Accountable Care Organization (ACO), and other insurance carriers
Collaboratively works with other associates, outside agencies and payors, providers, staff, and managers to coordinate and grow PCMH in SVPN clinic sites
Responsible for the coordination of PCMH processes including NCQA certification and BC/BS pilot project
RN Associates Degree required, BS/BA/BSN preferred
Current MT RN license
Minimum of (2) years of clinical nursing experience in an outpatient setting required or (2) years’ experience coaching individuals with complex and/or chronic conditions
Prior experience in care coordination in a community setting or primary care practice highly preferred
Program development, operations management and supervisory experience preferred
Must have and maintain current MT Driver’s license
Must show proof of insurability and of a clean driving record
Ability to successfully function in a fast paced, service oriented environment under limited supervision
Experience in understanding and usage of computers as well as the ability to learn applications relevant to the position. Must be able to effectively use Microsoft Office, including Microsoft Excel, Outlook, Meditech HCIS software and web based registry programs

222

Lpn Unit Care Coordinator Resume Examples & Samples

Must have attended an accredited LPN program
Must be currently licensed/registered in applicable State. Must maintain an active Licensed Practical/Vocational Nurse (LPN/LVN) license in good standing throughout employment
One (1) year geriatric nursing experience preferred
Must be able to coordinate patient care plans and services with RN

223

Care Coordinator / Discharge Planner Resume Examples & Samples

Completion of an accredited Licensed Vocational Nurse (LVN) program or Navy Corps School
Current California Licensed Vocational Nurse licensure
Excellent verbal and written communication skills; strong interpersonal skills
Must have excellent customer service skills, be flexible and very organized
One to three years’ experience in the acute patient care, SNF, home health, or hospice settings
Experience as a case manager or discharge planner interacting with managed care payers
Experience with InterQual or Milliman Guidelines
Understanding of the ICD-9 and CPT coding

224

Clinical Care Coordinator Resume Examples & Samples

Serves as a subject matter expert to both internal and external sources (e.g. providers, regulatory agencies, UM and policy) to provide education, consultation and training when indicated. Serves as a resource to guide, mentor and counsel others in regard to understanding the drivers of health care costs to improve member outcomes related to Plan benefits and resources
Collaborates, coordinates and communicates with the member’s treating provider(s) in more complex clinical situations requiring clinical and psycho-social intervention
May develop/implement case or condition-specific plans of care and/or intervention plan, as needed, that can become a part of the member’s EMR or medical record to establish short and long-term goals. Establishes a plan for regular contact ( face-to-face as often as possible) with each member and/or provider to monitor progress toward goals, provide additional education and evaluate the need for modification or change in the plan of care. Proactively incorporates lifestyle improvement opportunities and preventive care into member interactions and coaching
Collaborates with the appropriate individuals to offer solutions to refine and improve existing practices or participates in developing performance improvement processes that will enhance member outcomes and operational performance/excellence as well support all strategic initiatives. Works with providers related to performance measures and activities to educate and influence the behavior of members and providers
Ability to work in a virtual environment (e.g., provider offices, facilities and/or member’s homes); accomplishing and coordinating work remotely
Proficiency in MS Excel and enhanced data and statistical analysis skills
Excellent interpersonal/ consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization
Broad knowledge of the health care delivery system including an understanding of health care costs drivers
Excellent verbal and written communication skills including individual and/or group education/training
Experience working with the healthcare needs of diverse populations and understanding the importance of cultural competency in addressing targeted populations
Self-directed; self-starter; ability to work successfully with indirect supervision and moderate autonomy
Excellent organizational, time management and project management skills
Ability to work in a fast paced, high visibility, high performing team environment that requires flexibility
Ability to travel locally and work flexible hours in a practice or facility-based settings
Ability to communicate effectively in more than one language, preferred
Experience working directly with physicians in provider practice settings, members in a home environment or hospital discharge processes

225

Embeded Clinical Care Coordinator Resume Examples & Samples

Serves as a subject matter expert to both internal and external sources (e.g. providers, regulatory agencies, UM and policy.) to provide education, consultation and training when indicated. Serves as a resource to guide, mentor and counsel others in regard to understanding the drivers of health care costs to improve member outcomes related to Plan benefits and resources
Collaborates, coordinates and communicates with the member’s treating provider(s) in more complex clinical situations requiring clinical and psychosocial intervention
Collaborates with the appropriate individuals to offer solutions to refine and improve existing practices or participates in developing performance improvement processes that will enhance member outcomes and operational performance/excellence as well support all strategic initiatives including Health Care Reform and STARS initiatives. Works with providers related to performance measures and activities to educate and influence the behavior of members and providers
Ensures that all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements and accreditation standards that support all lines of business

226

Clinical Care Coordinator Rn-sanctuary Resume Examples & Samples

Assist in the development of preliminary and comprehensive assessments of the nursing needs of each resident. Review resident's medical and nursing treatments to ensure that they are provided in accordance with the resident's care plan and wishes
Ensure that all nursing personnel are in compliance with their respective job descriptions. Meet with the nursing staff, as well as support personnel in planning the department's services. Monitor that all departmental personnel follow established policies and procedures, including dress code
Attend various committee meetings of the community as required. Assist in preparing written and/or oral reports of the nursing service programs and activities to submit to such committees
Assists DON with incident reporting to assure complete documentation of occurrences. Analyzes data and develops appropriate action plans, identifies trends, patterns and outcomes
Assist the Education Director in developing, implementing, and conducting in-service training programs that relate to the nursing service department. Ensure the continuing education requirements, which allow licensed personnel to keep their license current
Admit, transfer and discharge residents as required
Monitors compliance and accuracy in Care Tracker
Graduate from an accredited approved Registered Nurse Program. Bachelor's of Science Degree in Nursing preferred
Must have a minimum of 1-2 year(s) experience in a supervisor capacity in a hospital, long-term care facility, or other related health care facility. Previous experience in rehabilitative and restorative nursing practices preferred
Must possess a current, unencumbered, active license to practice as an RN in the state
Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long-term care
Must possess and maintain current CPR Certification
Interpersonal skills to drive collaboration, commitment and productivity when working with cross-functional teams, customers and end users
Possess a high degree of personal accountability, responsibility and independent decision making abilities with the skills to plan, organize, develop, implement and interpret programs, goals, objectives, policies and procedures of the organization

227

Care Coordinator Ppmsi Resume Examples & Samples

Initiate and coordinate a multi-disciplinary team approach to care management which includes patients, payors, and providers across the care continuum
Work closely with the ACO Care Managers to target the high-risk, chronically ill patients and facilitate their enrollment in appropriate care management programs
Help patients to identify barriers to self-care and additional services that may be needed, such as home health care, caregiver support or community services
Respond to physician referrals for care coordination
Work with physicians and their office staff to help coordinate care for patients
Document assessments and encounters
Answer general care coordination questions
Promote patient self-management skills
Certification as a Medical Assistant and/or equivalent experience in a clinical setting
Minimum 3-5 years of previous experience in a managed care organization or other comparable experience
Experience and competence with Microsoft Office
Excellent telephonic skills
Ability to prioritize tasks and thrive in a highly productive environment
Familiarity with chronic disease management
Familiarity with current clinical practices for adult and pediatric clients

228

Field Care Coordinator Resume Examples & Samples

Assess, plan and implement care strategies that are individualized by enrollees and directed toward the most appropriate, lease restrictive level of care
Utilize both company and community-based resources to establish a safe and effective case management plan for individuals
Collaborate with individuals, families, healthcare providers and long-term care facilities to develop an individualized plan of care
Advocate for individuals and families as needed to ensure the individual's needs and choices are fully represented and supported by the healthcare team
Knowledge of social work principles practices and processes
Knowledge of Social Work theory and understanding of Social Work Code of Ethics
Knowledge of Crisis Intervention and Human Behavior and Development Life Cycle Theory
Knowledge of community resources, state and federal programs
Knowledge of individual and family therapy and to learn and understand medical terminology
Ability to prioritize multiple work assignments and manage time efficiently
Flexibility in accepting diverse work assignments and managing stress related to change
Knowledge of Medicare, Medicaid and third party payers
Ability to act independently within established procedures, policies and guidelines
Skilled in oral and written communications and in analytical problem-solving
Ability to exercise tact, judgment, and diplomacy
Ability to multi-task and critically think and to work with minimal supervision
Ability to relate to people in a manner to gain confidence and establish support
LCSW required (Social Work license must be in good standing in the state of Delaware)
One (1) year of social work experience with acute inpatient clinical practice and/or community based

229

Transitional Care Coordinator Resume Examples & Samples

Serves as the primary and secondary responder to all inbound phone calls
Assists the Intake department by supplying staffing solutions to new patient referrals
Accurately completes all workflow associated with staff requests for scheduling changes, caseload reassignments, recertification of services, new referral scheduling , missed visit, visit time exceptions, visit time change requests and all associated workflow as assigned and delegated by the Director of Nursing
Supports clinical leadership by maintaining the proper daily workflow of tasks
Referral sources
Ensures seamless transition of patients to home care by providing direct oversight of patient education and preparation for home care, plan of care initiation, and coordination of care with multiple service providers
Builds and monitors community and customer perceptions of Puget Sound Home Health as a high quality provider of services
Gathers, collates, and reports referral statistics including key customer referral trends
Maintains comprehensive working knowledge of Home Health contractual relationships and ensures that patients are admitted according to contract provisions
Communicates effectively, professionally, and thoroughly with staff regarding coordination of care expectations, educates and enforces deadlines, and establishes and maintains positive working relationships with current staff and contract staff
Demonstrates commitment, professional growth and competency
Provides insight to identify needs for additional staff
Maintains comprehensive working knowledge of contractual staff relationships
Serves as an administrative support resource for all clinical and marketing staff
Ensures compliance with all state, federal & Medicare regulatory requirements
Ensures compliance with all state, federal, and Joint Commission referral/intake regulatory requirements
Demonstrates strong written and oral communication skills in person, over the phone (verbal and text) and over email
Establishes productive organizational skills and habits
Provides excellent customer service skills
Strong team skills
Technical aptitude to know, learn and master the agency’s software
Ability to multi-task in a fast paced office environment
Promote and demonstrate company core values and mission
The above statements are only meant to be a representative summary of the major duties and responsibilities performed by the employee of this job. The employee may be requested to perform job-related tasks other than those stated in this description.**

230

Clinical Care Coordinator Resume Examples & Samples

Foster a collaborative relationship between providers, community agencies, managed care organizations, and Beacon staff in order to ensure members receive timely and integrated access to services across the continuum of care
Assist members in scheduling appointments and accessing community resources
Accurate and timely documentation in company database of member activities and interventions
Experience in customer service, preferably within a mental health related field
Must possess high-level written and verbal skills
Ability to recognize and/or anticipate the needs of customers and respond accordingly

231

Customer Care Coordinator Resume Examples & Samples

Answer homeowner and vendor questions and assist with understanding of warranty guidelines
Manage warranty service requests via email and the Meritage website
Communicate with construction, warranty and sales personnel to expedite warranty requests
Verify close of escrow dates to ensure warranty requests are valid
Ensure all customer care actions are aligned with current Meritage Homes’ warranty process guidelines
Input data, generate, process and distribute service requests and work orders in a timely manner
Maintain and track information using the E1 People Soft System
Oversee the emergency process by following up on all emergency calls, creating warranty requests and assisting field personnel to complete emergency repairs
Receive and direct calls from subcontractors
5+ years Customer Service and Admin experience
High School Diploma or equivalent. College Degree preferred
Strong organizational skills, ability to prioritize and multi task

232

Care Coordinator, LPN Resume Examples & Samples

Collaboration: Establishes and maintains relationships with patients, families, and healthcare providers; provides updates and communicates patient needs, concerns, and interests to SDCM or designee; assists in communication with patient/family related to follow-up care and/or services; and shares pertinent information
Assessment: Contributes to assessment of health status by: collecting, reporting, and recording objective and subjective data; observation of conditions or change of condition; signs and symptoms of deviation from normal health status
Identification of Health Care Problems: Assists in formulating lists of needs/problems
Establishment: Contributes to setting realistic and measurable goals by identifying patient-centered short and long-term goals
Planning a Strategy of Care: Participates in the development of the written patient-centered care plan; recognizes, understands, respects cultural, spiritual, religious issues, beliefs, needs, and rights to choice; assists in the identification of measures to maintain comfort; supports human functions; maintains an environment that is conducive to well-being; provides health teaching; and participates in the identification of priorities
Implementing of Strategy of Care: Encourages patient self-care and self-management; provides emotional support to patients; assist in promoting an environment that is conducive to safety and health; assists in patient teaching; and documents interventions and patient response to intervention(s)
Maintaining Safe and Effective Care: Consults with RN and seeks guidance as necessary; applies principles of infection control; and initiates Care Management policies and procedures as appropriate
Evaluating responses to Interventions: Documents and communicates outcomes of patient-centered care plan; assists with collection of evaluation data; and contributes to modification of strategy of care
Other: Additional duties within scope of practice; follows Care Management policies and procedures; verification of required Care Management competencies, certifications, and education
Must have excellent interpersonal, communication, motivational, and organizational skills
Ability to coordinate multiple projects, deadlines, and situations
Ability to respond promptly, correctly, and effectively to patient/family questions and/or concerns
Computer competence with MS Office applications
Demonstrated ability for use of customer service principles and good listening skills to effectively communicate with patients, families, and health care providers via telephone
Can work independently and cooperatively as an effective team member
Read, write, and speak fluent English. Additional languages a benefit
Demonstrates commitment to professional growth and competency
Minimum of 3 years, preferably 5 years of experience in a clinical setting (e.g. hospital, skilled nursing facility, home health)
Knowledge of care management and/or care transitions preferred

233

Costumer Care Coordinator Resume Examples & Samples

Secure fast and timely problem solutions towards our customers and maintain high quality
Ensure that order handling from A to Z in our ERP system is always handled & maintained for the customers within the area of responsibility
Follow up with customers as regards to orders, shipments and other requests
Build and maintain customer relationship
Coordinate requests, orders and shipments with other departments within the organization
Ad hoc projects and sales related tasks

234

Referral Management Care Coordinator Resume Examples & Samples

Serve as liaison between members of specific health plans and primary care providers and specialists, to coordinate referrals and help members and providers navigate the Steward provider network
Triage service requests
Create and process referrals
Use of a referral data tool to manage and retain care within the Steward network
Assist consumers with PCP and specialist selection
Schedule PCP and specialist appointments
Under the direction of the Medical Director and Sr. Manager, Insurance Products, communicates plan dispositions for out of network health care services members and PCP offices
Ensure accurate and timely processing of all requests
Receives incoming requests from physician practices and consumers
Verifies eligibility and coverage
Obtains insurance referrals
Assists with PCP selection
Schedules patient appointments by contacting physician practices or scheduling directly in electronic medical record
Registers consumers for system-wide events and screenings
Tracks consumer responses to a variety of marketing venues
Communicates with physician practices and patients as needed
Confirms appointments and/or referrals with physician practices and consumers
Assures that all necessary documentation occurs in a timely manner
Achieves established performance targets
Meets established quality expectations e.g. confidentiality, accuracy, customer service and professionalism
Covers triages function as needed
Supports other departmental team members to assure turnaround time expectations are met
Communicates important information to team members
Contributes to team efforts to improve workflow and efficiency
Provide Outstanding Customer Service
Goes the 'extra mile' to assure that customer expectations are met
Assists with other projects within the department on an "as needed" basis
Communicates effectively with internal and external customers with respect of differences in cultures, values, beliefs and ages, utilizing interpreters when needed
Exceptional Customer Service
Proficient with Microsoft Office programs
Ability to meet deadlines in high-pressure environment
Demonstrates effective interpersonal skills in intense situations
Knowledge of managed care concepts and medical terminology
Ability to multi task and work with multiple software applications
Knowledge of insurance, medical office practice and/or referral processing
Demonstrated ability to process insurance referrals and/or schedule physician appointments
Demonstrated understanding of the need for patient confidentiality in a HIPAA compliant environment
Demonstrated ability to work independently and as part of a team
Reliability
Knowledge of 3rd party payers

235

Senior Customer Care Coordinator Resume Examples & Samples

Client sensitive
Flexible on working hours / availability
Commercial and leadership potential

236

RN Care Coordinator Resume Examples & Samples

Serves as a primary representative of Hospice services during non-business hours, ensuring consistent and safe patient care, and high quality customer service
Answers questions for patients and their families via phone, gathering information needed for assessment of care needs
Coordinates Hospice staffing during non-business hours, delegating assignments to RNs, Home Health Aides, and other Hospice staff
Provides direct nursing care in the home or other facility settings (i.e., nursing homes) during non-business hours
Documents concerns and issues occurring during non-business hours to ensure follow up when business hours resume
Uses discretion and independent judgment to determine the urgency of issues and escalates to Chronic Care leadership during non-business hours as necessary
Demonstrates professional and compassionate communication through interactions with patients, their families, staff, and other members of the care team
Serves as a role model for other staff, exhibiting behaviors that promote a positive learning experience for staff and a compassionate end-of-life experience for patients and their families

237

Care Coordinator Resume Examples & Samples

Assumes role in assessment of patient physical, psychosocial and economic needs for effective transition of care planning to a variety of levels of care
In collaboration with the care team, facilitates the development and communication of the continuum of care transition plan to appropriate health service providers
Documents, verifies and validates specific data required to monitor and evaluate interventions and outcomes
Interviews and collects patient specified data and chart review related to readmission
Knowledgeable of and complies with accreditation and regulatory requirements. Integrates performance improvement principles and customer service principles into all aspects of job responsibilities
Obtains or ensures acquisition of appropriate pre-certification authorizations from third party payers and placement to appropriate level of care prior to hospitalization utilizing medical necessity criteria and third party guidelines. Obtains or facilitates acquisitions of urgent/emergent authorizations, continued stay authorizations and authorizations for post-acute services as needed and with compliance with all regulatory and contractual requirements
Documents, monitors, intervenes/resolves and reports clinical denials/appeals and retrospective payer audit denials. Collaboratively formulates plans of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and third party payers, etc
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc. Serves as a educational resource to all AHN staff regarding utilization review practice and governmental commercial payer guidelines. Adhere to the policies, procedures, rules, regulations and laws of the hospital and all federal and state regulatory bodies
Communicates telephonically and electronically with the outpatient providers in an effort to enhance the continuum of care
Assumes responsibility for AHN required continued education and own professional growth. Performs other duties as assigned or required

238

Individualized Care Coordinator Resume Examples & Samples

In-depth knowledge in technical or specialty area
Applies advanced skills to resolve complex problems independently
Works independently within established procedures; may receive general guidance on new assignments
Effectively handle general concerns and questions from clinic customers & escalate as needed
Be a resource to host training webinars for new MMS Pharmacy online customers
Effectively promote the benefits of using a specialty pharmacy to dialysis customers
Understand the relationship between Metro Medical and MMS Solutions and how each entity addresses needs within the dialysis community
Be a resource for clinic customers on the policies of MMS, including the ordering & returns process
Be responsible for all general tasks in the MMS online ordering system, including setting up new user profiles, maintaining the SKU inventory, adding new clinics & patients, What’s New Updates
Be a backup resource for monthly customer reports

239

Field Care Coordinator Resume Examples & Samples

Bachelor's Degree in Social Work, Sociology, Psychology, Gerontology or a related social services field
Minimum of 2 years of clinical or case management experience
Minimum of 2 years of experience in long - term care, home health, hospice, public health or assisted living
Ability / willingness to travel daily within the service delivery area (Pasco / West Pasco Counties)
Bilingual skills (fluency in Spanish) highly preferred
Basic level of proficiency in PC - based word processing and database documentation (Word, Excel, Internet, Outlook)

240

Care Coordinator for Caremore Case Management Resume Examples & Samples

2 years of experience in Case Management Care Coordination in an HMO environment; or any combination of education and experience, which would provide an equivalent background
This position requires strong communication skills with clinical staff
*Must be able to work in a very fast paced environment***

241

Field Care Coordinator Sarasota Resume Examples & Samples

Document all member assessments, care plan and referrals provided
Bachelor’s degree in Social Work or other related field
1 years of clinical or case management experience
1 year of experience in long-term care, home health, hospice, public health or assisted living
Bilingual (English / Spanish fluently)
A background working in geriatric special needs

242

Senior LTC Care Coordinator Resume Examples & Samples

Ability to manage assigned caseload with limited supervision. Provides timely, balanced and accurate claims reviews in a time sensitive and fast paced environment
Compiles file documentation requiring extensive policy and factual detail. Conducts in depth detailed information-gathering phone calls that obtain medical condition details and other information
Assist supervisor with complex case review and letter review
Partners with Supervisor to identify training needs and provide mentoring and coaching
Identifies issues and works with associates to increase individual and organizational capabilities
Partners with supervisor to resolve claimant escalations
Embraces and promotes change initiatives within LTC and assist supervisor with recognition
3+ years of claims experience
Strong technical and communication skills (written and oral)
Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning
Comfortable working with multiple priorities in a changing environment
Ability to prioritize and maintain quality

243

Care Coordinator, Welwyn Resume Examples & Samples

To assist in the day-to-day operation of the Home Care Service business, involving direct line management for a team of Home Care Workers. This includes the management of their weekly workload ensuring that services are delivered in line with their purchase order/private contract and that staff receive regular quarterly supervision
To participate as required in the multi-disciplinary assessment of Service User needs and the subsequent planning of Service User Care
To define special care needs based upon identification of specific clinical problems, and to monitor and review as appropriate
To liaise as needed with external organisations (CPN’s, chiropodists, GPs and other nursing professionals) in respect of developing a total package of care for a Service User, and ensuring that they are made aware of all changes in the Service Users condition pertinent to their condition
To report to the Branch Manager on a weekly basis on activity levels and outcomes for Service Users
To participate in staff development, training and performance appraisals
To comply with all Policies of the Organisation, as appropriate
To provide written reports of all complaints, accidents, incidents and untoward events in accordance with written Policies
To keep abreast of all new developments in Care, and of the philosophies and policies of the Contracting Authority, and to communicate the same to the staff of the Organisation, modifying Policies as needed
To ensure that the day-to-day Care Services are operated in accordance with Health & Safety legislation and current statutory regulation guidance on best practice
To conform to the Company Code of Professional Conduct in relation to the operation of the Home Care Service
To participate in Staff, Team and Quality Management Review Meetings as directed by the Branch Manager
To engage with and positively undertake on call duties as required by the branch to ensure a 24/7 service is provided

244

Care Coordinator Resume Examples & Samples

Interact with Member Service Representatives, Clinical Case Managers, and Service Coordinators to ensure members are receiving proper assistance
Utilize Pre-Review Screening tool, make appropriate provider referrals and/or refer to licensed clinician for clinical evaluation
Identify complaints and assist patients to exercise grievance rights
Identify calls requiring clinical evaluation or interpretation and refer to licensed clinician
Access Protected Health Information (PHI), Beacon/BCBHM and Health Plan Patient Files (ledger, authorizations, and administrative, claims, and clinical notes) and provider files as needed for Referral and Authorization
Experience working in a high call volume inbound call center within the healthcare industry preferred
Experience working with the delivery of healthcare, Medicare and/or Medicaid services
Working knowledge and understanding of medical terminology
Apply knowledge and skills to provide superior customer service to our members
Ability to multi task and utilize multiple computer screens
Ability to actively listen and resolve problems
Work effectively in a team environment
Provide timely and effective customer service in response to inbound member calls
Must type a minimum of 35 wpm

245

Embedded Nicu Clinical Care Coordinator Resume Examples & Samples

Communicate effectively while performing customer telephonic interviewing and communication with external contacts
Maintain knowledge of Medical Terminology and Medical Diagnostic Categories/Disease States
Collaborate with Primary Care Physicians, Medical Specialists, Home Health and other ancillary healthcare providers with the goal being to coordinate member care
Be knowledgeable of and consider benefit design and cost benefit analysis when planning a course of intervention in order to develop a realistic plan of care
Attend and participate in required meetings, including staff meetings, internal Rounds, and other in-services in order to enhance professional knowledge and competency for overall management of members
Educate health team colleagues of the role and responsibility of Case Management and the unique needs of the populations served in order to foster constructive and collaborative solutions to meet member needs
Bachelor’s degree in nursing or RN certification or Master’s degree in Social Work and 3 years experience in Acute or Managed Care/ experience with Medicaid or Medicare populations
3-5 years of experience in working in a NICU/Pediatrics population
Must have appropriate FBI Clearance and Child Abuse Clearances and Immunizations
Travel up to 50%
Bilingual English/Spanish language skills

246

Care Coordinator, Knightsbridge Resume Examples & Samples

Participate in the multi-disciplinary assessment of Service User needs and the subsequent planning of Service User Care
Defining any special care needs and liaising with external organisations (CPN’s, chiropodists, GPs etc.) to develop a total package of care
Report into the Branch Manager on a weekly basis on activity levels and outcomes for service user
Participate in staff development, training and appraisals and provide written reports of all complaints, accidents and incidents

247

Care Coordinator Resume Examples & Samples

Make the necessary patient arrangements for long distance trips. This may include but not be limited to hotel, airfare and transportation reservations
Learn and develop proficiency with A2C Administration system applications
Assist as needed in coordination of member trips with public transportation providers
Serves as a liaison with public transportation agencies. Maintain updated agency information including services, fares and route information
Build and maintain relationship with public transit providers. Coordinates and/or resolve issues, and conflicts
Active participant in the development of new service areas and identification/set up of public transit agencies
Identify ways to use public transit services and available resources to reduce trip costs and increase member utilization

248

Rn Unit Care Coordinator Resume Examples & Samples

One (1) year geriatric nursing experience required
Must be able to effectively direct the daily functions of unit nurses and CNAs to provide leadership on the floor
Must be able to chart appropriately, accurately, and in a timely manner
Must be able to provide, manage, and coordinate patient care and services through interpersonal contact which allows patients to attain or maintain the highest practicable physical, mental, and psychosocial well-being
Must be able to accurately prepare and administer medication as ordered by a physician

249

Temporary Care Coordinator Resume Examples & Samples

Provide individualized person-centered support to members
Serve as team coordinator of the Interdisciplinary Care Team (ICT) along with the PCP/BHP
Communicate all member care changes to the Interdisciplinary Care Team and others involved in the actions described in the ICP
Facilitates communication between the member or designated representative and the member’s PCP or psychiatrist and other healthcare providers, including transition of care activities
Collaborate with PCP, BHPs, members of the health care team, and others to arrange and coordinate services for the member to help member reach their highest level of functioning and optimize the member’s ability to engage in their plan of care
3-5 years’ experience in community based behavioral health support programs preferred
Experience with SMI population in acute care settings, or case management programs
Experience working with individuals of different cultural and ethnic backgrounds preferred
Managed care experience and familiarity with Medicaid and Medicare populations preferred
Intermediate knowledge with limited competency of Microsoft Word, Excel, and PowerPoint

250

Customer Care Coordinator Resume Examples & Samples

Log phone calls
Communicate phone call messages to appropriate Field Representative
Make sure customer received a call back from appropriate representative within a communicated time frame
Enter all inspection report information in the Siebel program as identified service orders
Send 90 Day and 330 Day histories to homeowners with cover letter
Send service orders via fax or email to all contractors with noted date for work and/or delinquent date
Make a service order entry identifying information in letters sent to customers on history
Weekly report of open service orders is to be generated and sent to the Field Representatives
Performs 90 and 330 day walks

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