Acute Care Coordinator

Acute Care Coordinators are the first line clinical representatives for Kaelo in response to requests for emergency care and other acute care access. They are responsible for the authorising access for the appropriate cases  telephonically or per email. Acute Care Coordinators load all hospital related cases for emergency department treatment and initial admission into hospital. Candidates will be required to issue authorisations for GP visits when clinically appropriate when transferred from the call centre. The role is expected to communicate with the clients on the benefit availability and limitations and communicate with all members of the clinical team to ensure appropriate early care coordination. This position reports to the Acute Care Team leader, who reports to the Clinical AdvisorNote: This job specification provides a general outline of the responsibilities and qualifications expected of an Acute Care Coordinator. Specific duties and requirements may vary depending on the organisation.Acute Care Coordinator Responsibilities and Key OutcomesResponsibilities include:The candidate will be expected to work shift work from time to time on a rostered basis to facilitate the operations of a 24 hour clinical service centre.1. Emergency Care CoordinationAnswering calls routed through for emergency department visits or hospital admission in the event of an emergency and provides appropriate authorisation.Review ambulance claims for appropriateness and correct Level of Care.Discussing diagnoses with doctors, specialists and other health care providers.Respond to clinical enquiries from the first encounter.2. Non-emergency acute care coordinationReceive calls from the call centre for members with consultations above the recommended annual limit and guide correctly based on clinical appropriateness. Conducting assessments of patient needs, such as mental health issues or substance abuse problems and refer to EAP where applicable.3. GeneralReport any clinical escalations/concerns to the Clinical Review Committee.Maintain confidentiality in clinical conditions shared with her/him.Load specialist authorisations on request.Educate patients on benefits and limitations based on their plan option.Ensure that Service Level Agreements are met.Key outcomes1.Utilize all resources and guidelines at his/her disposal to effectively assess, prioritize, advise, and manage patients presenting to the emergency department. 2.Thoroughly complete documentation utilizing the appropriate computer software in compliance with the approved policies and procedures.3.Maintain current nursing skills and knowledge base by attendance at workshops and seminars, completion of mandatory continued professional development, reading of professional journals, publications, and participation in professional organizations.