Care Coordination & Discharge Liaison

kaweahhealth; Visalia (CA); On-site; USD 60,000 - 75,000; Full time

Job summary

Kaweah Health in Visalia, CA is seeking a Care Coordination Specialist to support the Home Health Agency. You will gather clinical data, monitor quality, and act as liaison between Case Management and insurers to streamline authorizations and discharge planning.

Required are two years of health-related education and utilization review experience, with strong medical terminology, communication, and Excel skills.

Qualifications

• Two years of college or equivalent training/experience in a health-related field.
• Utilization review and/or coding experience.
• Must understand basic medical terminology.
• Strong organizational and multitasking skills with the ability to handle multiple patients.
• Excellent communication and interpersonal skills with patients and staff.
• Proficiency in Excel for documentation is preferred.

Responsibilities

• Reviews and records utilization review data for assigned caseload to keep inpatient records current.
• Refer variances to Case Management for concurrent review and report variances per policy.
• Review admissions and continued stay using InterQual criteria for appropriateness.
• Notify Case Management and physicians of questionable/denied cases and initiate actions per plan.
• Coordinate placement of patients in appropriate long-term care facilities.
• Arrange acute transfers to other facilities when indicated.
• Assist with discharge planning, including equipment, home care, and transportation.
• Participate in Continuum of Care rounds and link families to community resources.
• Answer calls, screen messages, and document per hospital protocol.
• Insurance Specialist duties: manage referrals, authorizations, and communicate payer needs to Case Managers.

Skills

Medical terminology

Organizational skills

Communication skills

Interdisciplinary collaboration

Excel proficiency

Education

Two years of college or health-related training

Tools

SoftMed

Invision

EMR documentation

Job description

Kaweah Health in Visalia, CA is seeking a Care Coordination Specialist to support the Home Health Agency. You will gather clinical data, monitor quality, and act as liaison between Case Management and insurers to streamline authorizations and discharge planning.

Required are two years of health-related education and utilization review experience, with strong medical terminology, communication, and Excel skills.