CASE COORDINATOR.

Job Title

CASE COORDINATOR

Job Family

Function

CORP (SME: CFO-CPHO)

Job Code

30009338

Reports to Job

Business Unit Lead

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

Strategic Roles & Responsibilities %

00

Strategic Roles & Responsibilities

Operational Roles & Responsibilities %

100

Operational Roles & Responsibilities

• Evaluate standard and routine requests from the various stakeholders based on patient benefits coverage agreements and medical necessity utilizing evidencebased tools to ensure patients receive quality costeffective care
• Coordinate patient care to meet the individuals and their familys needs and ensure patient safety quality of care and costeffective outcomes
• 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
• Assist in maintaining uptodate patient documentation and periodic reporting ensuring information completed efficiently and accurately and is readily accessible for review and audits
• Support the continuous patient care access and identifying and escalating 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 of experience in 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

Acknowledgement

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice

Addendum Title

No

Supplemental Work/Experience/Education Information

N/A

Addendum Description

N/A