The Care Coordination Program is a 90 day program following discharge from an acute or post-acute setting which includes a set of core program interventions that are directed toward the needs of members who are at risk for hospital readmission. A personalized care plan is developed based on patient assessments and a variety of clinical information obtained by the care team. The Care Coordination Program focuses on 6 pillars designed to promote a smooth transition to the home and prevent avoidable readmissions: Caregiver education. Medication reconciliation, Review of discharge instructions, Education on red flags, Follow-up physician appointments, Referrals to community resources
This position provides leadership and clinical operational oversight of the Post-Acute Care, Care coordination Program. Works alongside CareCentrix leadership teams for Product Development, Sales, Account and Clinical Management to establish and implement new programs and products to support CareCentrix position as an industry leader in post-acute care.
• Bachelor’s degree in nursing required.
• Current unrestricted /RN licensure along with a thorough and diverse knowledge of healthcare delivery, managed care regulations, utilization management, case management, and governmental home health agency regulations.
• A minimum of six to eight years’ experience in clinical operations and management of people.
• Experience in business and product development, preferred.
• Knowledge of State and Federal regulations in regard to Utilization Management and accreditation standards i.e. URAC, NCQA. Position requires strong writing, organizational, and communication skills, as well as strong business acumen.
• Due to the unique nature of the Post-Acute Care interventions, this position must be able to incorporate aspects of CM/DM into the patient self-management coaching model without building a traditional telephonic CM/DM department.
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.