Hospital Care Coordinator

Hospital Care Coordinators are responsible for end to end oversight of all in hospital cases for Kaelo clients. This includes management and coordination of care from the time that a patient is admitted throughout their hospital stay and discharge planning. A Hospital Care Coordinator is expected to provide appropriate authorisation updates on cases daily to ensure that optimal care is delivered to a patient at the most effective price point. They are expected to communicate with patients and providers on the benefit availability and limitations, review the correct level of care for admitted clients, and negotiate with health care providers.This position reports to the Clinical Operations Manager and is supervised by the Clinical/Medical Advisor.Note: This job specification provides a general outline of the responsibilities and qualifications expected of a Hospital Care Coordinator. Specific duties and requirements may vary depending on the organisation.Clinical Auditor Responsibilities and Key OutcomesResponsibilities include:Receive handover on cases admitted/authorised by the Acute Care Coordinators.Coordination of care for all hospital admitted patients.Ensure that correct benefit is utilised by member.Identify exclusions from the onset of request for treatment.Ensure that the correct level of care is allocated to the correct facility.Review appliances used in hospital against the current treatment guidelines.Provide information about treatment options, side effects, and possible complications of medications or procedures.Discussing diagnosis with doctors, specialists and other health care providers,Conducting assessments of patient needs, such as mental health issues or substance abuse problems and refer to EAP where applicable.Ensure service level agreements are metUse the latest available evidence based guidelines for patient management.Developing referral and treatment protocols for new or updated conditions identified.Report any clinical escalations/concerns to the Clinical Review Committee.Act as a patient advocate.Maintain confidentiality in clinical conditions shared with her/him.Assisting with monthly reporting: statistics, savings for example.Key outcomes Utilize all resources and guidelines at his/her disposal to effectively assess, prioritize, advise, and manage admitted patients.Thoroughly complete documentation utilizing the appropriate computer software in compliance with the approved policies and procedures.Maintain current nursing skills and knowledge base by attendance at workshops and seminars, completion of mandatory continued professional devemopment, reading of professional journals, publications, and participation in professional organizations.