Care Coordinators

DescriptionMeasurement Criteria : 1. Evaluate patients to determine care, discharge planning and other care needs. Communicate with attending physician and social worker to develop a comprehensive discharge Participates in the development and implementation of Case Management policies and protocols as related to patient care / services. Promote effective and efficient utilization of clinical Outcome (Results) : Goal achievement within ninety percent (90%) of established target. Essential Function? Yes No Percentage : 20%Responsibility : MethodologyComplete clinical reviews to be submitted to healthcare insurance provider.Measurement Criteria : 1. Assist in the evaluation of appropriateness of plan of care and revise on anongoing basis with communication to all other disciplines.Review diagnostic results to ensure that continuation of stay meets medical necessity. Complete daily clinical reviews and submit to healthcare insurance provider to review for medical Compare assessment data to baseline assessment to monitor patients' progress. Recognize changes in patient's condition and reports to healthcare insurance provider.Communicates with attending physician regarding patients' status with insurance coverage, g., denied days due to delay, lower level of care needed.Outcome {Res ults) : Timely completion of clinical reviews is achieved. Essential Function? Yes No Percentage : 85%Responsibility : Effectively assist in managing discharge planning. MethodologyMeasurement Criteria : I. Assess patients to obtain appropriate discharge placement. Integrate clinical needs in plan of care to ensure appropriate discharge plans are in Coordinate discharge plans with interdisciplinary team to ensure a safe and effective Participate in the development of patient goals and discharge plans; make revisions based on changes in patient Outcomes (Results) : Discharge planning goal met. Essential Function? Yes No Percentage : 20 % Responsibilin

• Monitor continuing services to ensure appropriate continuation of care. MethodologyMeasurement Criteria : 1. Monitor patient's condition to ensure continuation of services meets medical necessity.Remain flexible and responsive when changes occur in patients' Demonstrate appropriate judgment skills to make independent clinical decisions in routine patient Perform appropriate documentation to maintain the standards set by the hospital or fiscal Promote level of clinical expertise to ensure high quality of Adhere to the scope of practice for Registered Professional Nurse per State regulatoryOutcome (Results) : Medical Necessity Guidelines are met. Essential Function? Yes No Percentage : 80%Responsibility : Methodology Measurement Criteria : Outcome es ults) : Effectively work to ensure patient experience and other customer service (internal and external) goals are met. Works with hospital leaders and staff to establish departmental patient experience Mobilizes department staff to become actively involved with improving patient Works with staff to meet established patient experiencePatient experience goals are achieved within ninety percent (90%) of goal target.Essential Function? Yes No Percentage : 10%Requirements 1. Performs comprehensive assessment of physical, psychosocial, and environmental needs of the patient including outcome and assessment information2. Evaluate patients to determine care, discharge planning and other care needs.Communicate with attending physician and social worker to develop a comprehensive discharge Participates in the development and implementation of Case Management policies and protocols as related to patient care / services.Promote effective and efficient utilization of clinical3. Complete clinical reviews to be submitted to healthcare insurance provider4. Assist in the evaluation of appropriateness of plan of care and revise on anongoing basis with communication to all other disciplines.Review diagnostic results to ensure that continuation of stay meets medical necessity. Complete daily clinical reviews and submit to healthcare insurance provider to review for medical Compare assessment data to baseline assessment to monitor patients' progress. Recognize changes in patient's condition and reports to healthcare insurance provider.Communicates with attending physician regarding patients' status with insurance coverage, g., denied days due to delay, lower level of care needed. UMC Employee Core CompetenciesDecision Making - Uses sound judgment to make good decisions based on information gathered and analyzed. Considers all pertinent facts and alternatives before deciding on the most appropriate action and commits to decisions.Teamwork / Collaboration - Interacts with people effectively. Able and willing to share and receive information. Co-operates within the group and across groups. Supports group decisions. Place group goals ahead of own goals.Work Standards - Sets and maintains high performance standards. Pays close attention to detail, accuracy and completeness. Shows concern for all aspects of the job. Follows-up on work outputs.Motivation - Displays energy and enthusiasm in approaching the job. Commits to putting additional effort towards goals andjob expectations. Maintains a high level of productivity; self-directed.Reliability - Takes personal responsibility for job performance. Completes work in a timely and consistent manner; sticks to commitments.Problem Solving - Analyzes problem by gathering and organizing all relevant information. Identifies cause and effect relationships. Comes up with appropriate solutions.Adaptability - Adapts to changing work environments, work priorities and organizational needs. Able toeffectively deal with change and diverse people.Planning and Organizing - Plans and organizes tasks and work responsibilities to achieve objectives. Sets priorities. Schedules activities. Allocates and uses resources properly.Communication - Expresses ideas effectively. Organizes and delivers information appropriately. Listens actively.Integrity - Shares complete and accurate information. Maintains confidentiality. Adheres to organizational policies and procedures. Meets own commitments.Initiative - Takes action to influence events. Generates ideas for improvement, takes advantage of opportunities, suggests innovations