Care Coordinator RN remote work: Baton Rouge or New Orleans Join to apply for the Care Coordinator RN remote work: Baton Rouge or New Orleans role at eQHealth Solutions .
Job Responsibilities Perform care coordination services for assigned recipients eligible for home health services, including home health visits, PPEC, personal care, and private duty nursing, based on contract requirements.
Use discretion to approve or validate utilization reviews (UR) or escalate to the second level. Provide first-level authorization review for inpatient and outpatient services requiring approval, including prospective, urgent/non-urgent, concurrent, and retrospective reviews.
Complete prior authorizations promptly and accurately.
Conduct initial assessments to recommend appropriate home health evaluations unless already completed within the fiscal year.
Perform home and/or PPEC visits as needed or required by contract.
Schedule and lead initial face-to-face meetings with recipients and their guardians in the home or PPEC.
Assess, plan, implement, monitor, and evaluate the recipient’s healthcare needs and services.
Document assessments, actions, outcomes, and all communication in the Care Coordination System within one business day.
Identify patient care issues and collaborate with families and healthcare teams to develop and update care plans.
Maintain regular contact with recipients and guardians to update care plans, resolve issues, and identify additional needs.
Participate in multidisciplinary team meetings and contribute to comprehensive care planning.
Monitor caseload eligibility status monthly and manage transitions, including Skilled Nursing Facility (SNF) placements and community re-integrations.
Serve as a resource to the community and manage workload related to quality reviews and case follow-ups.
Prioritize requests and develop cooperative relationships while maintaining confidentiality.
Provide courteous, prompt service to internal and external customers.
Attend staff meetings, continuing education, and participate in quality improvement initiatives.
Assist with special projects and perform other duties as assigned.
Job Details Seniority level: Entry level
Employment type: Full-time
Job function: Other
Industries: IT Services and IT Consulting
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