Surgical Clinical Care Coordinator (Surgical C3) - Care Navigation

Welcome to Montage Health’s application process!

Job Description:

Position Summary

The Surgical Clinical Care Coordinator is the gatekeeper of Surgical Services, providing the Hub early visibility of admissions to enable proactive bed planning, ensuring every admission is appropriately statused, and preventing avoidable admissions.

Key Responsibilities:

• Acts as a spoke of the Hub by partnering with other Care Coordinators to facilitate each patient’s care

• Works proactively with surgical staff, PACU charge nurse, and surgeons to identify potential admissions, and communicates admissions and patient needs to the Hub

• Reviews future OR schedule and validates accuracy of patient status (inpatient, outpatient, observation)

• Verifies pre-authorization/pre-certification is obtained on each patient when required

• Identifies inpatient Medicare/Medicaid procedures and ensures order, OR schedule, and other applicable systems reflect inpatient status

• For planned admissions, anticipates discharge needs and begin discharge planning if possible

• Evaluates and manages appropriate patient admissions

• Collaborates with Surgical staff to identify variations between planned and final surgery and updates accordingly (status, LOS, diagnosis, delays, etc.)

• Considers alternatives to admission for patients who do not meet criteria for admission

• Ensures documentation of admission orders per policy

• Discusses and advises physicians regarding patient admission status determination and those that do not meet admission order criteria (inpatient vs. observation vs. discharge)

• Partners with PACU staff to facilitate patient flow out of the PACU

• Serves as a consultant and educator with surgical staff regarding patient status, bed placement, payor requirements, and utilization of resources.

• Identifies and initiates discharge planning for skilled needs.

Experience

• 5 years current acute care hospital experience preferred.

• Broad clinical expertise to evaluate patient diagnosis and treatment plan and outcomes utilizing established criteria.

• Effective communication, customer and public relations skills.

• Ability to work as an integral member of the interdisciplinary assessment team.

• Strong organization skills.

• Knowledge of financial reimbursement, state, federal and commercial insurance requirements preferred.

• Knowledge of community resources preferred.

• Acute hospital case management experience preferred.

• Utilization Management experience preferred

• Surgical Services experience preferred

Education

Bachelor’s degree in nursing preferred.

Must pass orientation and initial competency assessment prior to independent assignment of patients requiring the applicable skill, and must complete and pass all annual competencies.

Licensure/Certifications

State of California RN license required. American Heart Association Healthcare Provider BLS required.

Equal Opportunity Employer

Assigned Work Hours:

Part Time, 0.7 FTE

M-F

5-6 hour shifts

variable day shift

no weekends, no holidays

Position Type:

Pay Range (based on years of applicable experience):

to

The hours employees work determine when a shift differential is paid.