CASE COORDINATION SPECIALIST.

Job Title

Job Family

Function

Job Code

Reports to Job

Job Description Summary

Strategic Roles & Responsibilities %

Strategic Roles & Responsibilities

• Participate in regular team meetings to discuss Case progress share updates and identify areas for Process Improvement
• Coordinate with internal and external stakeholders to ensure seamless communication and efficient Case resolution

Operational Roles & Responsibilities %

Operational Roles & Responsibilities

• Evaluate standard to complex requests from the various stakeholders based on patient benefits coverage agreements and medical necessity utilizing evidencebased tools to ensure patients receive quality costeffective care
• Coordinate patient care to meet the individuals and their familys needs and ensure patient safety quality of care and costeffective 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 uptodate patient documentation and periodic reporting ensuring information completed efficiently and accurately and is readily accessible for review and audits
• Support the continuous patient care access and identifying and escalating anomalies to avoid patient care interruptions

Minimum Education Required

Professional Certifications Required

Years of Experience

Languages

Functional Competencies

• Due Diligence
• Audit Reporting
• Data Collection

Core Competencies

• Excellence
• Integrity
• Accountability
• Cybersecurity
• Person-Centered Care

Acknowledgement

Addendum Title

Supplemental Work/Experience/Education Information

Addendum Description