CASE COORDINATOR.

Overview

The Case Coordinator independently handles daily operations for a designated patient caseload by assessing, planning, and facilitating the coordination of patient care and evaluating the appropriateness of care utilizing evidence-based tools to ensure smooth patient access and cost-effective outcomes.

Responsibilities

• Evaluate standard and routine requests from the various stakeholders based on patient benefits coverage agreements and medical necessity utilizing evidence-based tools to ensure patients receive quality cost-effective care
• Coordinate patient care to meet the individuals and their family's needs and ensure patient safety, quality of care and cost-effective outcomes
• Coordinate processing of standard case review and documentation including logging, tracking and resolution following established protocols and within defined service level agreements (SLAs) or provider contracts
• Assist in maintaining up-to-date patient documentation and periodic reporting ensuring information completed efficiently and accurately and is readily accessible for review and audits
• Support continuous patient care access by identifying and escalating anomalies to avoid patient care interruptions

Qualifications

Professional Certifications Required

Refer to applicable JD Addendum

Languages

English : Fully Proficient; Arabic : Not Required

Core Competencies

Acknowledgement

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Supplemental Work / Experience / Education Information

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