ED Care Coordinator

ED Care Coordinator/MSW - Full Time

Day Shift 7:00 AM - 7:30 PM

Under the direction of the Care Integration Manager (LCSW) and clinical oversight by the Vice President of Quality and Regulatory Affairs (LCSW), the ED Care Coordinator uses pre-established guidelines and criteria to perform review activities assuring proper utilization of hospital resources for Medicare, Medi-Cal, HMOs and other third party payers.

• Takes appropriate follow up action when established criteria for utilization of services are not met, in order to assure that denials are avoided.
• Identifies medically indigent patients and monitors closely to ensure that appropriate placement is secured; works with patient and family to determine if other sources of funding may be applicable.
• Maintains appropriate documentation of review performed, according to pre-established criteria, indicating severity of illness and intensity of services rendered with acute/ post-acute hospitalization.
• Serves as Liaison with physician(s) to: ( ) ensure all covered aspects of treatment are fully documented, and (2) assists in identifying other options for care when patient no longer requires acute hospitalization.
• Secures appropriate discharge planning and home health services, and long-term care placement.

• To perform this job successfully, an individual must have a Master's in Social Work, or in a Health Related Field. Certification in Case Management desirable. Must have and maintain current BLS certification or obtain within orientation process, prior to hands-on patient care. One (1) year or more experience in an Acute Care setting desirable and one year experience with discharge planning highly desired.
• Individual must possess excellent computer skills and have knowledge of Windows.
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.