Care Coordinator Licensed
Glendale , CO 80246
Posted 11 months ago
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Exciting opportunity to join the nation's largest provider of healthcare services with over 1000 practice locations!HealthONE, a part of the HCA Healthcare family, is the largest healthcare system in the metro Denver area providing modern, culturally competent, patient-centered care and we are driven by a single goal: the care and improvement of human life.We are looking for an exceptional Care Coordinator Licensed to join our team. We believe in our team and your ability to help us provide high quality, compassionate care in the communities we serve.We offer an excellent benefits package, competitive salary, tuition reimbursement, and growth opportunities. We are seeking a great addition to the team who feels patient care is as important as we do!Interested in learning more about us? Click here!POSITION SUMMARY:As a Care Coordinator, you act as an integral member of the Quality and Government Programs department to support PSG practices in successfully meeting CMS, ACO and payer quality initiatives in assigned Division(s). Assist Director of Care Coordination in developing structure and processes to aid the assigned Division(s) in successfully meeting quality initiatives.JOB DUTIES INCLUDE BUT ARE NOT LIMITED TO:* Serve as subject matter expert in quality and value based incentive programs from CMS, ACOs, or payers. * Monitor patient compliance regarding preventative care using Care Vantage and payer reporting. * Access specific portals to obtain data for preparation of reports and prepare reports and other documents to evaluate the progress of quality programs. * Attend CPC learning sessions and share information learned to team members. * Under supervision of Director or Care Coordination Lead, communicate results of CAHPS survey to team in appropriate document. * Maintain patient charting as needed and perform medical record review during HEDIS and MRA projects. * Identify care gaps as defined by quality and value based program metrics through review of payer and program reports, as well as enterprise developed tools (i.e. Care Vantage). Communicate via telephone with patients regarding care needed and document communication appropriately in the electronic medical record. * Schedule appointments related to preventative care and chronic conditions based on identified care gaps. * Work with hospital counterparts following patient discharge. Help facilitate post discharge care coordination based on discharge follow-up recommendations to reduce unnecessary readmissions. * Ability to assist patients with navigation of the provider network and other community based organizations based on their needs. * Assist in submitting necessary documentation for annual PAFs. * Under the supervision of the Director or Care Coordination Lead, assist in the development of tools, education and workflow processes to assist the Division(s) in meeting CMS, ACO, EHR eCQM workflows, coding, and Payer quality initiatives. * Conduct in person and WebEx meetings with practice managers, staff, providers and managers to communicate program goals and provide education. * Maintains comprehensive knowledge of payer and regulatory requirements with ability to work effectively under pressure. Keeps abreast of industry trends and guides team to adapt to meet evolving needs of payers, government programs and the healthcare industry. * Collaborates with interdisciplinary teams and leaders (PSG, SPA, Quality, ACO leaders and care coordinators, and Govt Programs) to achieve the organization's coordination of care goals, quality goals, and financial performance goals. * Prepares and maintains care coordination reports and prepares periodic reports for senior management, as required.EXPERIENCE:* Graduate of an accredited college or nursing school as an RN or LPN. * Current licensure as an RN or LPN in state of residence. * Working knowledge of Microsoft Office, PowerPoint, Internet, Adobe, and MS Outlook. * Prefer knowledge of Patient Centered Medical Home (PCMH), CPC , government programs (CMS), accountable care organizations (ACOs), HEDIS, and experience with payer cost sharing initiatives. * Ability to prepare quality data reports with attention to detail. * Working knowledge of electronic medical records, medical terminology, ICD-10, CPT 11 coding, HEDIS measures, and medical office processes (preferred). * Knowledge of physician office practice operations. * Self-motivated and flexible to the changing needs of the program, team and work environment with the ability to self-direct including prioritization of multiple simultaneous tasks. * Ability to interpret and apply guidelines and procedures and maintain quality control standards. * One (1) year of experience in a physician practice is preferred.We believe in going above and beyond, and feel that there is no nobler pursuit than that of caring for and improving human life. We hope you'll join us on our mission!