CASE COORDINATOR.

Job Description Summary
The Case Coordinator independently handles daily operations for a designated patient caseload by assessing, planning, and facilitating the coordination of patient care and evaluates appropriateness of care utilizing evidence-based tools to ensure smooth patient access and cost-effective outcomes.

Operational Roles & Responsibilities

1. Evaluate standard and routine requests from the various stakeholders based on patient benefits coverage agreements and medical necessity utilizing evidence-based tools to ensure patients receive quality cost-effective care.
2. Coordinate patient care to meet the individuals and their families' needs and ensure patient safety, quality of care, and cost-effective outcomes.
3. 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.
4. Assist in maintaining up-to-date patient documentation and periodic reporting ensuring information is completed efficiently and accurately and is readily accessible for review and audits.
5. Support the continuous patient care access and identify and escalate anomalies to avoid patient care interruptions.

Minimum Education Required
Bachelor's Degree in Nursing or Medicine.

Professional Certifications Required
Refer to applicable JD Addendum.

Years of Experience
3-5 years of experience in a relevant field.

Languages
English: Fully Proficient; Arabic: Not Required.

Functional Competencies
• Due Diligence
• Audit Reporting
• Data Collection

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