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Behavioral Health Care Coordinator
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$37.15 - $41.36 an hour
Full-time
- RN or Social Worker (LCSW/LMSW)
- In addition, they will perform eligibility and benefit reviews as necessary, discharge planning, identification of patients for case management, quality improvement reviews, education of the member/family, provider and hospital staff, and communication with inpatient care coordinators, case managers, home care reviewers, members, providers, Member Services, Claims, Contracts and Benefits - Appeals, Risk Management.
- Maintains effective interaction/communication with members of the medical staff, nursing staff, complex case managers, the SNF rounder, home care review team, social workers, inpatient care coordinators, referral coordinators, Member Services, Claims, Contracts and Benefits-Appeals, Risk Management and Kaiser Permanente medical offices to facilitate the precertification and referral process.
- Attends QRM Hospital UM meetings as requested.
- Under the guidance of the Supervisor, Telephonic Inpatient Care Coordination and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures.
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