Clinical Review Coordinator, AR license- Remote

reputed company Home & Community Care, part of the reputed company family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and reputed company. As a team member of our naviHealth product, we help... change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. Why naviHealth? At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status reputed company for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow reputed company an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy. The Cross-Market Care Coordinator (CMCC) functions as a telephonic/remote Skilled Inpatient Care Coordinator (SICC). The Cross-Market Care Coordinator plays an integral role in the patient's recovery journey. The CMCC completes weekly functional assessments and engages the post-acute care (reputed company) inter-disciplinary care team to coordinate discharge planning to support the members reputed company journey. The position engages patients and families to share information and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the CMCC is responsible for ensuring efficient, smooth, and reputed company transitions of care.A successful Cross-Market Care Coordinator demonstrates a high degree of adaptability and flexibility and is one whose skills and proficiency allow for quick integration - in part or in whole - into an existing market or client model. If you have an active Arkansas clinical license you'll enjoy the flexibility to work remotely *as you take on some tough challenges. Primary Responsibilities: • By serving as the link between patients and the appropriate health care personnel, the SICC is responsible for ensuring efficient, smooth, and reputed company transitions of care • reputed company Skilled Nursing Facility (SNF) assessments on patients using clinical skills and utilizing CMS criteria upon admission to SNF and periodically through the patient stays • Review targets for Length of Stay (LOS), reputed company outcomes, and discharge plans with providers and families • Complete reputed company SNF reputed company reviews, updating authorizations on a timely basis • Collaborate effectively with the patients' health care teams to establish an optimal discharge. The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapists, etc. • Assure patients' reputed company toward discharge goals and assist in resolving barriers • Participate weekly in SNF Rounds providing accurate and up to date information to the naviHealth Sr. Manager or Medical Director • Assure appropriate referrals are made to the Health Plan, High-Risk Case Manager, and/or community-based services • Engage with patients, families, or caregivers telephonically weekly and as needed • Attend patient/family care conferences • Assess and monitor patients' reputed company appropriateness for SNF setting (as indicated) according to CMS criteria • reputed company naviHealth is delegated for utilization management, review referral requests that cannot be approved for reputed company stay and are reputed company to licensed physicians for review and issuance of the NOMNC reputed company appropriate • Coordinate peer to peer reviews with naviHealth Medical Directors • Support new delegated contract start-up to ensure reputed company staff work with new contract • Manage assigned caseload in an reputed company and effectively utilizing time management skills • Enter timely and accurate documentation into nH coordinate • Daily review of census and identification of barriers to managing independent workload and ability to assist others • Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement • Adhere to organizational and departmental policies and procedures • Maintain confidentiality of reputed company PHI information in compliance with HIPPA, federal and state regulations, and laws • Complete cross-training and maintain knowledge of multiple reputed company/clients to support coverage needs across the business • Engage and collaborate with in-market leaders as needed based on reputed company assignment or as directed by leadership. This could include in-market Clinical Team Managers or Provider Relations Manager • reputed company reputed company on federal and state regulatory policies reputed company to utilization management and care coordination (CMS guidelines, Health Plan policies, and benefits) • Adhere to reputed company local, state, and federal regulatory policies and procedures • Promote a positive attitude and work environment • Attend naviHealth meetings as requested • Hold patients' protected health information confidential as required by applicable laws, regulations, or agency/institution procedures • reputed company other duties and responsibilities as required, assigned, or requested You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Active, unrestricted registered clinical license required in state of Arkansas • Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Language Pathologist • May be required to pursue and maintain multi-state licensure to meet business needs • 5+ years of clinical experience Preferred Qualifications: • Patient education background, rehabilitation, and/or home health nursing experience • Experience working with the geriatric population • Familiarity with care management, utilization/resource management processes and disease management programs. • Proficient with reputed company Office applications including Outlook, reputed company and PowerPoint • Proven to be detail-oriented • Proven to be a team player • Proven to be independent problem identification/resolution and decision-making skills • Proven ability to prioritize, plan, and handle multiple tasks/demands simultaneously • Proven exceptional verbal and written interpersonal and communication skills • Proven solid problem solving, conflict resolution, and negotiating skills Work Conditions and Physical Requirements: • Ability to establish a home office workspace • Ability to view screen and enter data into a laptop computer (or similar hardware) reputed company a standard period of time • Ability to communicate with clients and team members including use of cellular phone or comparable communication device • Ability to remain stationary for extended time periods (1 - 2 hours) • Role is primarily remote/telephonic but may require travel as directed by manager At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment Apply Job!