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A hospital administrator sitting next to her computer, talking with a colleague.
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Two advanced practice nurses talking with a female patient who is sitting on an examination table
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Two physical therapists and a nurse helping a female hospital patient to walk
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A hospital office worker sitting next to her computer, talking with a colleague
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A hospital customer service representative and a patient transporter escorting a patient in a wheelchair
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A hospital facilities worker operating a floor cleaning machine
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A hospital finance department worker having a virtual meeting on her computer
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A hospital human resources worker sitting next to her computer, talking with a colleague
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A hospital IT or cybersecurity worker looking at a rack of computers
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Hospital laboratory workers working with high-tech machines in a laboratory
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A hospital marketing communications professional having a virtual meeting on her computer.
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Two nurses talking with a female patient who is sitting on an examination table
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Two advanced practice nurses talking with a female patient who is sitting on an examination table
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Two nurses giving care to a female patient in a hospital ward
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Nurse working with a patient at the bedside
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A young nursing graduate viewing a patient monitor in a hospital ward
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Two occupational therapists and a nurse helping a female hospital patient to walk
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Two pharmacists working together within a hospital pharmacy
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A doctor talking with three nurses in a hospital ward setting
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A hospital office worker sitting at her desk looking at a computer screen.
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A research technician using a machine to test samples in a hospital laboratory
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Three student nurses standing in a row in a hospital ward setting
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A hospital office worker sitting at her desk looking at a computer screen
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Care Management Coordinator

Cleveland, OH, US


req#: 277479
Location: Cleveland, OH

Facilities: Remote Location,

Professional Area: Quality

Department: 8216 Utilization Review-Indian River Hospital

Job Code: 000108

Schedule: Full Time

Shift: Days

Care Management Coordinator  

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will work alongside passionate and dedicated caregivers, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.    

As a Care Management Coordinator, you will support the organization and team through securing authorizations, securing approved bed days and organizing the department’s schedule and daily assignments.  

This is a remote Florida opportunity with somedays in office at Indian River Hospital.

A caregiver in this position works 8:00am – 4:30pm.  

A caregiver who excels in this role will:  

  • Recommend resource utilization.  

  • Facilitate efficient Care Management services. 

  • Monitor compliance with assigned responsibilities, complete daily/weekly tasks and coordinate with patient financial services. 

  • Conduct InterQual initial and continued stay reviews, initial and continued stay clinical authorization and 7- and 10-day LOS clinical and financial justifications. 

  • Ensure coverage for 24/7 on-call process and weekend coverage. 

  • Conduct daily analysis of reports on observation status reviews, daily comparison of anticipated discharges to actual discharges by IM team and attending physician and weekly analysis of assigned tasks of each case manager to ensure completion of Allscripts/ECIN documentation necessary for clinical LOC justification and payer reimbursement. 

  • Distribute results of reports on the efficiency and completion of Care Management activities with staff for staff input, follow-up and feedback. 

  • Ensure InterQual and Allscripts/ECIN reports are distributed to each staff member for action to address identified issues. 

  • Provide daily/weekly reports to the Director of Clinical Process and Risk Management regarding actions taken to assure full compliance with staff performance expectations. 

  • Coordinate authorizations, initial and concurrent clinical reviews, submission of data to payers and status of Kepro data entry with all assigned case managers. 

  • Ensure that both Care Management and Patient Financial Staff have documented authorizations in both Allscripts/ECIN and Invision to ensure Hospital payment for care provided. 

  • Ensures unit/department is staffed to provide adequate coverage appropriate to meet service needs. 

  • Maintain departmental files to assure competency with all assigned tasks and compliance with applicable regulations and standards. 

  • Ensure compliance with CMS/Medicare regulations. 

  • Provide staff training as needed on the access and use of all IT programs including Invision, Allscripts/ECIN, Epic and KEPRO.  

  • Maintain confidentiality and ensure compliance with CMS/Medicare regulations. 

  • Documents, circulates and maintains minutes of staff meetings. 

  • Completes bi-weekly payroll and payroll variance reports as required. 

Minimum qualifications for the ideal future caregiver include:  

  • Knowledge of financial and utilization review software, including ECIN, InterQual and Kepro. 

  • Two years of hospital care management experience.  

Preferred qualifications for the ideal future caregiver include: 

  • Knowledge of and/or experience with Epic, Word and Excel.  

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/  

Physical Requirements:

  • Requires frequent walking from department to department: require sitting at a work-station or desk.
  • Requires standing.
  • Work may include occasional publishing and/or pulling, lifting and carrying objects weighing up to 20 pounds such as files, documents and computer printouts.
  • Work requires finger dexterity and eye/hand coordination to operate a computer keyboard at a moderate skill level.

Personal Protective Equipment:

  • Follows standard precautions using personal protective equipment as required.

Pay Range

Minimum hourly: $18.88

Maximum hourly: $28.80

The pay range displayed on this job posting reflects the anticipated range for new hires. While the pay range is displayed as an hourly rate, Cleveland Clinic recruiters will clarify whether the compensation is hourly or salary. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set, and education. This is not inclusive of the value of Cleveland Clinic’s benefits package, which includes among other benefits, healthcare/dental/vision and retirement.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All new caregivers must clear a nicotine test within their 90-day new hire period. Candidates for employment who are impacted by Cleveland Clinic Health System’s Smoking Policy will be permitted to reapply for open positions after one year.
Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility.

Please review the Equal Employment Opportunity poster

Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities

Contact a recruiter

Brittany

Apply Today!

Contact a recruiter

Brittany