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Clinical Care Coordinator - Remote Opportunity at Keystone Peer Review Organization, Inc. in Tampa, Florida

Posted in Health Care 30+ days ago.

Type: Full-Time





Job Description:

KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.


Clinical Care Coordinator


 


**Must reside within 200 miles of either Tampa FL, Harrisburg PA or Seven Hills OH**


 


Summary Description 


The Clinical Care Coordinator role will act as a patient advocate during the appeals process by providing the Immediate Advocacy between the patient and the facility to ensure that the patient has what is needed to be discharge safely or that services can be terminated safely with adequate preparation for the changes. The Clinical Care Coordinator will work closely with the social workers who are currently and will continue to do Immediate Advocacy with beneficiary callers. They will collaborate with the PFE Health Educator for creating and presenting educational programs to staff and others, work closely with the BFCC Outreach Staff for communication, and help coordinate PFE activities within the BFCC office.


Accountabilities 



  • Perform direct beneficiary/family advocacy to resolve issues.

  • Coaches beneficiary/family for positive interactions with the healthcare community.

  • Coordinate PFE activities within the office.

  • Interact with providers/plans to improve PFE efforts.

  • Provides education and resources to beneficiaries/families/providers.

  • Work with data analytics team to identify opportunities for improvement, high-risk target populations, and evaluation.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time. 


Qualifications 



  • Bachelor’s degree in Nursing required.

  • Active, unrestricted with current State licensure.

Knowledge, Skills, Abilities 



  • Knowledge and familiarity with public sector health coverage systems, e.g. Medicare / Medicaid.

  • Knowledge of principles, ethics, and precepts of care management service delivery.

  • Knowledge of customer service principles.

  • Knowledge of medical terminology.

  • Knowledge of regulatory and accreditation standards.

  • Strong written and verbal communication skills.

  • Strong field and telephonic interviewing skills.

  • Strong computer skills, e.g. care management applications, Internet/Web, Microsoft Office (Word, Excel).

  • Strong prioritization and organizational skills.

  • Ability to demonstrate purposeful and outcomes directed critical thinking within daily operational activities.

  • Ability to receive verbal and written feedback in a professional manner and implement performance and productivity improvements as needed.

  • Ability to interpret real-time and historical information to inform delivery on overall accountabilities. 

Experience 



  • Four years progressively responsible experience in case management communications advocacy.

  • Experience with project coordination.

Mental and Physical Requirements               


The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.


KEPRO offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.   


EOE AA M/F/Vet/Disability


KEPRO is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

See job description





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