Job Overview:
The Clinical Episode Coordinator will utilize skilled intervention, clinical best practice knowledge and collaboration with the patient, physician and multidisciplinary treatment team to pace care, achieve quality outcomes and negotiate appropriate reimbursement. The Clinical Episode Coordinator will ensure the timely and seamless clinical transition of patients through medically appropriate levels of care.
Qualifications:
Required:
Preferred:
Certifications and Licenses Required:
Essential Job Functions
Serves as a critical component of the value-based operations care management team. He or she will oversee coordination of care for all patients enrolled in one or more value-based programs including CJR, MSSP, HRRP, and all other contracted programs while the patient is in an acute care setting.
For Medicare patients enrolled in Comprehensive Joint Replacement (CJR) lives, the Episode Coordinator s responsibility includes engaging the patient directly at the bedside, providing the beneficiary notification, and working with the patient s interdisciplinary team which includes the patient, family, caregiver, Orthopedic service line coordinator, and clinical care team to coordinate an appropriate and safe discharge plan to a post-acute or home setting.
For Medicare patients enrolled in a Medicare Shared Savings Program (MSSP) and/or Hospital Reduction Readmission Program (HRRP), the Episode Coordinator will participate in interdisciplinary rounds and coordinate with the hospital care team to identify next site of care discharge disposition.
For all other contracted payers under population health, the Episode Coordinator will participate in interdisciplinary rounds and coordinate with the hospital care team to identify next site of care discharge disposition.
Conduct a follow up phone call after the patient has been discharged from an acute care setting to home, to screen patients for safe discharge, and escalate any clinical issues to a Nurse Care Manager as needed for clinical interventions.
Reports directly to the centralized value-based operations care management team ensuring strong alignment and continuity of care for patients to avoid any overlapping outreach.
The Episode Coordinators will be provided with a risk stratification tool and Value Based Care criteria to focus and prioritize efforts.
Essential Job Functions Cont.
Other Duties:
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.
Additional Information:
At RWJBarnabas Health, our market-competitive Total Rewards package provides comprehensive benefits and resources to support our employees physical, emotional, social, and financial health.
Choosing RWJBarnabas Health!
RWJBarnabas Health is the premier health care destination providing patient-centered,
high-quality academic medicine in a compassionate and equitable manner, while delivering
a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.
RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.
Equal Opportunity Employer
RWJBarnabas Health is an Equal Opportunity Employer
