Clinical Care Coordinator

Clinical Care Coordinator

The Clinical Care Coordinator is responsible for coordinating and facilitating the continuum of care for patients admitted to the Rehabilitation Hospital of the Pacific. The role integrates utilization management, discharge planning, interdisciplinary collaboration, payer communication, patient advocacy, regulatory compliance, and transition-of-care coordination to promote safe, timely, and appropriate patient progression throughout the rehabilitation stay.

The Clinical Care Coordinator functions as a central member of the interdisciplinary rehabilitation team and serves as a liaison between patients, families, physicians, nursing, therapy disciplines, payers, community resources, and post-acute providers. The position supports patient-centered care while ensuring compliance with CMS regulations, IRF standards, payer requirements, and organizational policies.

Wage Range: $83,208.31 to $124,812.48/year. The actual wage is dependent on the applicant's relevant experience and qualifications for this position. The wage range for this position may be subject to change in the future depending on a variety of factors such as market conditions, business needs, legal developments, and other appropriate factors.

Required Qualifications:

• Certification/Licensure: One of the following, depending on discipline:
• Registered Nurse (RN)
• Licensed Clinical Social Worker (LCSW)
• Licensed Social Worker (LSW)
• Current BLS certification
• Completion of competencies and other job-related and REHAB requirements.

• Education: Bachelor's degree in Nursing, Social Work, Case Management, Healthcare Administration, or related healthcare field required.

• Skills/Experience: Ability to safely and effectively manage patients' mobility.

Preferred Qualifications:

• Certification/Licensure: Certified Case Manager (CCM), Accredited Case Manager (ACM)
• Education: Bachelor's degree in Nursing or Master's degree in Nursing or Social Work
• Skills/Experience: Minimum of 1 year of acute care, rehabilitation, case management, or care coordination experience. Experience with utilization review, discharge planning, and payer communication. Knowledge of rehabilitation diagnoses and functional outcomes and post-acute levels of care.

Core Values: Models REHAB's core values, HEART, in daily actions. Honesty Speak and act with truth and respect. Engagement Embrace and commit to our mission, vision and values. Aloha Serve others with a spirit of kindness and compassion. Resilience Rebound and recover with a sense of urgency. Teamwork Work together for success.

Essential Functions:

• Comprehensive care coordination by assessing the potential barriers to discharge, facilitating interdisciplinary communication, coordinating transitions across the continuum of care, advocacy, and assistance with complex discharge planning to ensure safe and timely patient transition.
• Utilization review and medical necessity by monitoring progress and therapy participation while collaborating with providers and payers for authorizations, appropriate continued stays, and ensuring compliance with CMS regulations, payer requirements, and IRF standards.
• Discharge planning and transition of care
• Interdisciplinary team collaboration
• Patient advocacy and education
• Regulatory compliance and documentation by ensuring compliance with CMS regulations, IRF criteria, payer requirements, hospital policies, HIPAA, accreditation stands, and patient rights. Support quality improvement initiatives, regulatory readiness, and organization goals related to length of stay, readmission prevention, and care transition.
• Quality improvement and operation responsibilities
• High-risk and complex case management
• Uses sound judgment and ensures patient safety.
• Follows and adheres to all organizational and departmental policies and guidelines, code of conduct, and REHAB employee handbook.
• Performs other duties as assigned.

Professionalism and Compliance Competencies: Maintain a high level of proficiency in the following REHAB competencies.

Job Knowledge

Accountability

Communication and interpersonal/relationship building skills

Adaptability and problem solving, decision making

Organization and project management

Equipment, tools, work aids used: Office equipment, including telephone, computer and multifunction devices (MFDs). Google's G Suite, report writer and database software.