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Care Coordinator - RN remote any Florida city

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Job Description - Care Coordinator - RN remote any Florida city


  • Performs care coordination services for assigned recipients who are eligible for home health services (Home Health Visits, PPEC, Personal Care Services and/or Private Duty Nursing Services etc. based on contract requirements).

  • Uses discretion to approve/validate UR or forward to 2nd level reviewer. Provides first level utilization review for all inpatient and outpatient services requiring authorization: Prospective Review Urgent/ Non-urgent, Concurrent Review and Retrospective Review.

  • Completes prior authorizations as appropriate in a timely manner.



  • Conducts an initial survey to recommend appropriate (home health assessment) for the recipient, unless this has already been done during the current fiscal year

  • Conducts a home and/or PPEC visit as needed or if contract requirement

  • Schedules and convenes initial face-to-face meeting in the recipient’s home and/or PPEC comprised of the recipient (if able) and the parent or legal guardian.

  • Assesses, plans, implements, monitors and evaluates the options and services required to meet the recipient’s health care needs.



  • Documents recipient’s assessment findings, actions, and outcomes.

  • Documents all communication, interventions and follow up tasks in the Care Coordination System within one (1) business day of each intervention and/or encounter.



  • Identifies patient care issues and makes recommendations on patient care issues.

  • Collaborates with the parent or legal guardian and healthcare team to arrange for identified home care needs.



  • Responsible for maintaining regular monthly contact (telephonically or face-to-face) with the recipient and the recipient’s parent or legal guardian.for purpose of updating Plan of Care (POC), resolving issues and identifying additional issues



  • As part of the multidisciplinary team, regularly meets with the team and contributes to the development of a comprehensive plan of care based on the needs of the recipient and recipient’s parent or legal guardian.

  • Evaluates and modifies recipient’s the plan of care as needed.  Regularly communicates changes to the recipient’s parent or legal guardian, healthcare team, and other agencies involved in the recipient’s care.



  • Monitors assigned caseload eligibility status on a monthly basis, based on their status in MMIS.

  • Completes a Staffing Tool (Freedom of Choice) any time a parent or legal guardian expresses the desire to reconsider a recipient’s placement into a Skilled Nursing Facility

  • Follow guidelines for additional required calls and visits for Skilled Nursing Facility (SNF) transitions to community settings for six (6) months.



  • Functions as a resource to the community.

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