Care Coordination Resume Sample
Work Experience
- Assists clinical coordination in the development and on-going management of designated staff
- Regularly monitors the performance of care coordination staff. Monitors adherence to the efficiency goals for all staff including case volume, case closure rates, average handle time and other metrics
- Two years of vocational training,medical office experience or relevant work experience required
- Demonstrated experience in Microsoft Office, typing, and computer data entry
- Medical office/ healthcare administrative experience or relevant work experience required
- Demonstrated experience in Microsoft Office
- Typing, and computer data entry
- Represents Magellan medical/clinical management policy at such meetings
- Completes a comprehensive assessment of the client’s holistic health status and needs to include clinical condition, support systems and resources, client/family knowledge, perception and adjustment towards disease process, and community resources
- Screens patients/clients for identified and potential needs. Makes referral to appropriate multi-disciplinary services
- Develops and utilizes tools available to effectively evaluate, summarize and communicate patient’s progress toward outcomes to members of the healthcare team and patient and family
- Collaborates with Unit Director in strategies/tactics to achieve unit based goals such as quality, financial, and safety indicators
- Demonstrates a wide theory/research base that supports sound clinical and psychological orientation. Specific knowledge regarding pathophysiology, natural history of disease processes, and impact on functional ability and level of care
- Customer focus and close alignment with the customers’ business objectives
- Determines staffing levels, interviews, and recommends for hire and evaluates staff, counsels and confronts unsatisfactory performance promptly and fairly and administers corrective action
- Work efficiently in a fast-paced environment with changing priorities
- Ensuring efficient and effective care transition for patients and families across the care continuum
- Work ng collaboratively and in partnership with patient care leaders in all settings
- Facilitating organizational compliance with applicable regulatory, licensing, accreditation standards
- Providing leadership within the interdisciplinary team to achieve desired clinical, financial, compliance, and resource outcomes
- Oversees the day to day processes in place for care coordination requirements with Managed Care Organizations (MCOs) as defined by customer
- Facilitates meetings in which care coordination issues are presented
- Recommends practice adjustments, policy and procedure revisions, training and support in an effort to provide continuous improvement to care coordination and access to care
Education
Professional Skills
- Interprets clinical findings, promptly communicates assessment and treatment plan updates, and provides effective consultation on patient care issues to health care team and agency representatives,
- Demonstrated ability to apply analytical and problem solving skills Demonstrated ability to manage multiple tasks or projects effectively
- Excellent communication skills, including the ability to respond and resolve customer concerns
- Excellent supervisory skills, including oversight of timeliness of work product and staff efficiencies
- Skilled in establishing and ordering multiple priorities to meet overall goals and objectives
- Operational experience including 7+ years managerial experience
- Two years of vocational training, medical office experience or relevant work experience required
How to write Care Coordination Resume
Care Coordination role is responsible for research, telecommunications, finance, training, integration, auditing, oncology, reporting, education, insurance.
To write great resume for care coordination job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Care Coordination Resume
The section contact information is important in your care coordination resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Care Coordination Resume
The section work experience is an essential part of your care coordination resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous care coordination responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular care coordination position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Care Coordination resume experience can include:
- Identifies department goals and objectives, develops and communicates action plans through regular staff meetings and other communications, uses team approach to problem solving and sets clear expectations
- In collaboration with Care Coordination educator, identifies training needs and develops and participates in staff training. Provides a challenging, supportive environment and delegates appropriately. Seeks additional training opportunities through outside sources
- In collaboration with the Director of Care Coordination, develops monitoring systems and measurements for the CC team and exhibits a customer service philosophy
- Strong analytical, research and data interpretation skills
- Excellent organization, time management and verbal and written communication skills
- Use communication skills using appropriate medical terminology
Education on a Care Coordination Resume
Make sure to make education a priority on your care coordination resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your care coordination experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Care Coordination Resume
When listing skills on your care coordination resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical care coordination skills:
- Strong communication and interpersonal skills – written & verbal
- Analytical problem solving/decision making and judgment skills
- Demonstrate experience in Microsoft Office, typing, and computer data entery
- Intermediate to advanced PC skills, word processing, spreadsheets and PowerPoint
- Strong ability to work independently and prioritize
- Prior experience in a job where coordination of activities was a primary function
List of Typical Experience For a Care Coordination Resume
Experience For Senior Care Coordination Specialist Resume
- Communicate clearly, concisely and effectively verbally and in writing
- Prior experience within healthcare including a background in value-based payments and care coordination
- Experience in a clinical setting building and leading a care coordination or care management program function
- Nursing experience specialty (RNC)
- RN with license in good standing
- Assist with coordination and management of team projects, set priorities
- Teamwork – demonstrates a willingness to assist co-workers and to accept additional assignments as requested to support the department efficiently
Experience For Care Coordination Assistant Resume
- 5). Creates data priorities and report formats that display critical outcome factors
- 16). Establishes effective communication systems and forums with third party payers and the local QIO/PRO
- Assessing needs of families’ aging loved ones and developing services plan
- Planning, leading and organizing the resources of a team
- Analyzing, interpreting and presenting financial utilization data
- Leading innovative case management programs and teams
Experience For Care Coordination Supervisor Resume
- Collaborates with Utilization Management staff regarding payer information, level of care and status determinations for patients
- Understands and self manages to support facility/CIN level success goals; including improvements in quality, cost of care and member experience for the facility/CIN’s population
- Receptive to constructive feedback and coaching; Demonstrates the ability to be kind, compassionate, considerate, approachable, friendly and open-minded
- Escalates calls to an RN warranting comprehensive assessments/ clinical triage
- Establish open patient communication using patient outreach encounters
- Compiles data, analyzes the data and develops innovation workflow coaching staff to reach defined goals
Experience For Supervisor, Care Coordination Resume
- Oversight of the day-to-day operations and staff for a Clinical pod, including Intake and Assessment and Care Coordination Staff
- Participate in strategic, systems, and organizational planning of department and the company as a whole
- 4). Responsible for all aspects of utilization review including observation management, clinical reviews, denials and appeals
- 6). Provides feedback to the department staff regarding Case Management sensitive data findings
- 7). Identifies appropriate staffing levels, assignments, and deployment for the department
- 14). Establishes a Utilization Management Committee, participates in the selection of standing agenda items, and provides reports and data to be reviewed
- Assess the healthcare systems ability to perform risk-based contracting and develop care coordination programs to fill identified gaps
Experience For Director, Integrated Care Coordination Resume
- Additional requests for licensure as identified during employment, applications to be submitted within 45 days of request
- Expertise in utilization management and discharge planning
- Work from epic dashboards to identify high risk patients
- Verify all patient referrals are kept, emergency room visits have follow up with provider
- Give patient follow up care instructions as directed by provider
- Assist patient with appropriate referral to community resources
- Capable of accurate, legal, and ethical documentation at all times
- Maintains compliancy within regulatory agencies such as HIPAA, OSHA and CLIA and JCAHO if applicable
- Ability and flexibility to cover various positions in CCM department
Experience For Care Coordination & Recovery Section Manager Resume
- Supervisors care coordination staff, including hiring, training evaluating performance and competency, and conducting disciplinary/counseling sessions as needed
- Manages Care Coordination program, outreach, utilization, disease management and other clinical based activities to manage patient preventive and chronic health conditions ensuring a plan of care for patients in all stages of health needs
- Collaborates and develops a effective working relationship with payors, medical staff, clinic managers, and staff as it relates to care coordination and integrated service delivery
- Works closely with all departments at INTEGRIS and the post-acute service providers to streamline the patient transition through the health care system and into the community post discharge
- Applies state, federal and other regulatory agencies functions and standards
Experience For Manager of Care Coordination Resume
- Ensures assigned Beacon clinical pod completes of all requirements of the program as outlined by DMAS, including meeting face-to-face with members and ICTs as necessary and appropriate, timely completion of work product, documentation standards are followed, and general adherence to all relevant policies and procedures
- Partnership with the Lead Care Manager, who is responsible for the clinical oversight of the pod’s work, in managing day to day operations
- Partnership with other clinical pod Supervisor’s, under the direction of the Director, Clinical Services, to ensure process and procedures are followed consistently, and the program operations run seamlessly
- Ensures assigned staff complete of all requirements of the program as outlined by Arkansas Medicaid, including meeting face-to-face with members, timely completion of work product, documentation standards are followed, and general adherence to all relevant policies and procedures
- Responsible for identifying operational issues which could impact clients and members
- Ensure process and procedures are followed consistently, and the program operations run seamlessly
Experience For Director Care Coordination Resume
- 1). Establishes implements and evaluates a strategic plan for the department that takes into account internal and external factors
- 2). Working with physicians, patients, families, and the multidisciplinary team in the acute care, rehab, skilled nursing facility, homecare, community and physician practice setting to optimize quality and efficiency outcomes; and decrease total medical expenses
- 3). Collaborates with health plan Case Managers to facilitate post-acute care and homecare services for identified patients
- 8). Establishes role descriptions and performance criteria for staff members
- 9). Develops and administers the budget for the department
- 10). Identifies organizational needs and concerns in payer-provider contracts and contributes to related negotiations
- 12). Establishes processes and policies that adhere to Joint Commission standards as well as CMS Conditions of Participation and other regulations
Experience For Administrative Assistant, Care Coordination Resume
- 13). Collaborates with Compliance to ensure developed processes and policies meet compliance standards
- 15). Develops structures and processes to facilitate participation by physicians, pharmacists, nurses, social workers and other health professionals in multidisciplinary care planning, care delivery, and discharge planning
- 17). Develops and maintains effective relationships with hospital department heads, nursing managers and administrators, and the administrative staff
- 18). Evaluates and optimizes patient satisfaction with discharge planning functions
- 19). Works collaboratively with all services including ACO, to prevent possibilities of readmission
- 20). Directs utilization review activities for the hospital, interfacing with external payers and review companies to determine appropriate medical necessity of admissions and continued hospitalization
- Proactively anticipates and recognizes priority needs for the executives and staff
Experience For Care Coordination Analyst Resume
- 21). Resolves conflicts related to discharge planning with patients/families, external agencies and payers
- 23). Establishes policies, procedures and protocols for departmental functions
- 24). Establishes a structure and process to address the CMS RAC initiative related issues within the organization that is aligned with other departments such as Finance and Compliance
- 25). Responsible for implementation of polices and procedures related to hospital based case management, utilization review
- 26). Manages assigned staff. Hires, terminates, assesses performance, recommends salaries and rates, recommends assignments, promotions, and demotions, and provides counsel and feedback. Develops staff. Schedules and assigns work. Develops programs to optimize staff performance
- Directs and manages areas including planning, organizing and directs all activities, staffing, performance improvement in the delivery of clinical services (such as LOS reduction). Reports needs within the Medical Center and Dignity Health, as well as government and regulatory reporting
- Guides Care Coordination activities according to the needs, requirements, and policies of the Medical Center, the affiliated medical groups and health plans, Dignity Health, any Federal and State agencies, and according to standard practices of the professions under the director's accountability
- Works closely with all departments at the medical center and the post-acute service providers to streamline the patient transition through the health care system and into the community post discharge
List of Typical Skills For a Care Coordination Resume
Skills For Senior Care Coordination Specialist Resume
- Work effectively in a fast paced environment, directing and managing multiple and complex projects
- Mentor staff in regards to current skills and continued professional development
- Upervisory experience or 1 year experience in a leadership role (preceptor, process improvement facilitator, clinical educator) required
- Experience involving utilization management/review, fiscal management, patient accounts, coding and or discharge planning
- Strong working knowledge of current medications, dosing information and prescribing requirements
- Experience establishing, negotiating and facilitating collaborative relationships
- Experience managing human resource issues, staff conflict resolution, group dynamics, scheduling of staff and disciplinary matters essential
- Skilled in communicating with all levels of the organization both orally and in writing
Skills For Care Coordination Assistant Resume
- Identifies cost-effective resources while providing quality care to reach the desired outcome
- Current California licensure in good standing as a Sutter Care Coordination Case Manager, Licensed Clinical Social Worker (LCSW)
- Previous experience using Microsoft Suite
- Experience in a nursing leadership position (manager or director level)
- Experience in Oncology Nursing
- Nursing experience, case/utilization management or quality improvement in a healthcare environment, preferably managed care
- Demonstrated ability to apply analytical and problem solving
- Previous experience working with the transgender community
- Proven commitment to providing incredible customer service both internally and externally
Skills For Care Coordination Supervisor Resume
- Customer Service Experience and/or Scheduling/Coordination
- Experience and expertise in utilization management, revenue cycle operations, care facilitation and discharge planning
- Demonstrated working relationships with physicians
- Two years of progressive experience in nursing management is required
- Demonstrated ability to communicate verbally and in writing to internal and external constituencies
Skills For Supervisor, Care Coordination Resume
- Experience with financial budgets and tracking of expenses essential
- Skilled in administrative and clinical research for achieving best practices
- Ensure tasks assigned to staff are progressing efficiently and are re-organized as priorities shift
- Sound judgment and experience working with confidential/sensitive information
- Solid understanding of healthcare systems, terminology, processes, policies, roles and practices
- One year previous experience in hospital insurance pre-certification or scheduling required
- Strong working knowledge MS Office suite
- Experience working with Managed Care Organizations is required
- Conducts a comprehensive needs and risk assessment of the patient (and family/caregiver with consent) to prioritize needs and resource allocation
Skills For Director, Integrated Care Coordination Resume
- Ensures leadership accountability for safe, efficient and effective utilization and coordination of staff, materials, supplies and equipment
- 11). Establishes effective relationships with individual physicians, physician groups, and physician organizational structures
- Demonstrates ability to identify problems and make reasonable recommendations and/or take the necessary action to resolve
- Staffing coverage: Primary contact for unplanned daily PTO needs being responsible for coordinating coverage of employee of unplanned PTO
- Contacting policyholders to complete intakes, prepare them for their in-home assessments and scheduling nurses to perform those assessments
- Working knowledge of the Microsoft Office suite required
- Training in Six Sigma, lean process methodology and PDCA
Skills For Care Coordination & Recovery Section Manager Resume
- Utilizing Lean principles to motivate people and drive change
- Following appropriate legal and ethical professional conduct
- Recording patient interview and history
- Providing patient education with regards to office policies, medications, management of diseased, home treatments and special diets
- Managing all aspects of your assigned caseload, within contractual service level guidelines as defined by each customer relationship
- Documenting case actions in a timely and succinct manner
- Responsible for training, meetings, scheduling, monitoring productivity, and overall management of the assigned Clinical pod
Skills For Manager of Care Coordination Resume
- Responsible for training, meetings, scheduling, monitoring productivity, and overall management of assigned staff
- Addresses the medical, nursing and/or personal care needs of the patient to enable their return to an optimal level of functioning
- Responsible for creating and maintaining a Care Coordination manual with information on all programs, flow/org charts, processes, timelines, FAQs
- Assist patient in dietary monitoring and home glucose monitoring when applicable
- Proficient with computer applications such as MS Office, email, desktop faxing and other office procedures
- Proficiency in typing and data entry required
- Hourly rate starting at $20.00/hour
- High integrity with a passion for learning about the long-term care industry
- Work remotely, including access to reliable internet
Skills For Director Care Coordination Resume
- Knowledge of payer requirements and discharge planning regulations that support the effect development of departmental policies, procedures and standards
- Problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge
- Knowledge of emerging healthcare reform initiatives required
- One to three years in a health care setting
- Quarterly Journaling and completion of annual PEAKs
- Work with provider and patient to establish personalized patient goals then work with patient toward achieving those goals
- Create electronic ongoing plan of care specific to patient's needs
- Establish patient's social, safety, financial, and fitness status so to understand and develop appropriated rapport for ongoing health care communication
Skills For Administrative Assistant, Care Coordination Resume
- Maintain chronic care management minute tracking throughout the month and drop appropriate charges as directed
- Assist patient with the scheduling of healthcare services or specialist referrals
- E-scribing prescriptions to pharmacy as directed by physician
- Capable of scheduling future appointments and referrals as necessary
- Refrain from discussing Patient Health Information in public in accordance with HIPAA guidelines and policies
- Education: HS diploma or equivalent required. Completion of LPN Educational Training Program required
Skills For Care Coordination Analyst Resume
- 22). Facilitates transition of patients/families across the continuum by establishing relationships with appropriate providers and community services
- Identifies support systems that indicate actual or potential problems and sets health care goals based on needs and risk assessment findings
- Re-assesses the member’s progress towards identified care goals and collaborates with the multidisciplinary health care team to adjust the patient’s care plan, as medically appropriate
- Ensures system/process is in place to deal with emergency/high-risk patients
- Follows up with patients when certified of conditions covered in the federal health program to identify needed services and coordinate care accordingly
- Ensures referrals are coordinated and service summary reports are maintained in the electronic health record (EHR) system
List of Typical Responsibilities For a Care Coordination Resume
Responsibilities For Senior Care Coordination Specialist Resume
- Develop positive, effective relationships with payers, pre and post hospital providers and referral sources to facilitate appropriate utilization of clinical services and innovative care coordination initiatives
- Work with staff and in multi-disciplinary teams (including the hospitalists and other attending physicians) to resolve issues related to difficult placements and discharge planning needs of patients
- Motivate both internal and external customers and communicate effectively at all levels
- Time management skills and ability to work in a high-pressure, deadline-driven environment
- Experience dealing with Medicare, Medicaid, government and CMS regulations
- BSN or RN with 3 years home and community based experience
- Home and community based experience
- Geriatric experience
Responsibilities For Care Coordination Assistant Resume
- MSHO Care Management experience
- At least two years of case management experience
- Demonstrated current knowledge of care management operations
- Leadership experience
- Experience in managed care, medical home or integrated case management environment required
- Establish priorities, meets deadlines, and develop and manage the department?s productivity standard in the management of work assignments
Responsibilities For Care Coordination Supervisor Resume
- Clinical experience across the continuum of care (physician practice, home care, acute care and post-acute care) highly desirable
- Knowledge and experience with interpersonal interaction and change theory essential
- Clinical experience in the care of people with HIV/AIDS
- Performance management and effective leadership
- Answer questions and meeting requests directed to executives by being aware of the business and personal objectives
- Participates in maintaining and monitoring the work environment to ensure a continual state of CMS and Joint Commission readiness
- Point of contact responsible for assuming essential requests and/or concerns, facilitating issues to the manager
Responsibilities For Supervisor, Care Coordination Resume
- Direct the process of assessment, planning, facilitation and advocacy of options and services that meet patients' health needs
- Collaborate with service line administration to adjust care strategies to accomplish established goals
- Use Process Improvement models to evaluate and improve processes that contribute to optimal patients' flow through the healthcare system within St. Joseph Healthcare and in collaborating with other providers outside of St. Joseph Healthcare
- Develop policies, protocols and tools in conjunction with key stakeholders
- Prepare and monitor budgets
- Provide outcomes reports on key indicators related to process measures, outcome measures, care coordination, resource utilization and compliance working collaboratively with key quality and compliance staff
- Build and maintain effective partnerships with external providers of care (nursing homes, home health agencies, physicians, etc.) to meet the needs of patients and families focusing on patient centered principles
- Develop a dashboard in conjunction with members of the Quality department for the Care Coordination Team to track processes (patient satisfaction, readmission rates, length of stay, inpatient denials, appeals, etc.)
- Represents the department by welcoming visitors, reviewing correspondence; arranging company dinners and other corporate functions
Responsibilities For Director, Integrated Care Coordination Resume
- Assure compliance with regulatory and payor requirements related to level of care, notice to beneficiaries for lack of medical necessity, etc
- Hire and discipline staff, provide performance evaluations of staff, supervise orientation and training of staff and perform other responsibilities related to employee matters, as required
- Perform other responsibilities as the needs arise
- Licensure as a R.N. in New Hampshire
- Assist patients navigate the healthcare system
Responsibilities For Care Coordination & Recovery Section Manager Resume
- Conserves executive's time by reading, researching, and routing correspondence; drafting letters and documents; collecting data for reporting purposes; initiating telecommunications
- Manages the department head's schedules, screens calls and navigates the organization to seek information
- Advance knowledge in Word, Excel, PowerPoint and Outlook, and the ability to learn new software applications
- Explore and implement opportunities to add value though work accomplishments
- Update job knowledge by participating in education opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
- Handle confidential and sensitive matters with discretion
- Knowledge of and expertise within social determinants of health and/or population health
- Develop policies, procedures, and workflows
Responsibilities For Manager of Care Coordination Resume
- Highly motivated and reliable with attention to detail
- Knowledgeable of insurance benefits terminology
- View problems and issues from multiple perspectives
- Knowledge of organizational policies and system-wide procedures
- Works in collaboration with the Case Management and Social Work teams in activities related to discharge placement, care coordination, and community referrals
- Under the supervision of a Case Manager, Social Worker or other licensed provider, obtains, sends and/or faxes patient information to external agencies or providers following hospital policy related to confidentiality
- Communicates professionally and establishes effective working relationship with internal and external customers. Performs multiple, concurrent tasks in frequently stressful and fast-paced environments while maintaining strong internal and external customer service standards
Responsibilities For Director Care Coordination Resume
- Completes follow up calls to clients and their care providers at the request of the Case Manager, Social Worker, or other licensed provider. Is able to elicit information during follow up calls and understands when to have a Case Manager, Social Worker, or other licensed provider intervene
- Coordinates appointments with physicians, testing and other services when appropriate. Schedules follow-up appointments as justified by physician order
- Provides verbal and written confirmation of appointments to patients/families. Documents the patients'/families' agreement and understanding of schedule. Faxes appointment confirmations to the appropriate community provider
- Assists within a discharge timeframe and with appropriate discharge placement
- Issues and documents Medicare or other communication provided to patient/families (e.g., IML for Medicare beneficiaries) as needed
- The Care Coordination Representative demonstrates the ability to read, comprehend, understand and interpret complex medical guidelines to determine if appropriate information has been provided in utilization reviews before transmission to external payers for review of medical necessity for Inpatient admission
Responsibilities For Administrative Assistant, Care Coordination Resume
- Transmission of utilization reviews to external payers - Analyzes and interprets medical guidelines to determine if appropriate information has been provided in utilization reviews prior to transmission to commercial external payers
- Provide support for the care coordination department - Receives sorts, files, and routes high volumes of mails, emails, and faxes from different types of vendors, analyzes and interprets the information and take appropriate actions including direct response to the requests or escalation to appropriate level of authority for resolution
- Promote customer service with internal and external customers - Ability to listen, analyze and interpret customer needs and direct them appropriately - Answers the department queue line and responds to customer needs in a timely and efficient manner by taking ownership
- Compiles, produces, distribute operational reports - Run daily, weekly, monthly and/or ad hoc reports for immediate distribution
- CA Registered Nurse required
Responsibilities For Care Coordination Analyst Resume
- CA Registered Nurse License required
- Team assignment management for coverage of all THPG PCP providers/clinics and inpatient facilities (Continuum of Care)
- Participates in hiring, performance review, and disciplinary actions in coordination with the department Manager. Ensures that new employees are oriented and trained appropriately
- Designs, executes, and delivers effective system of internal controls applicable and in compliance to laws, regulations, and internal policies and procedures. Ensures compliance with policies and procedures
- Provide feedback based on field interactions to manager
- Lead and/or participate on committees and project teams that support Care Coordination strategies and tactics as delegated by manager
- Current licensure as a Registered Nurse in state of residence
- PHN, Geriatric Case Manager