Care Coordinator in Phoenix, Arizona

**Direct Hire Opportunity**
Concentric Healthcare Staffing is a leader in the healthcare recruiting and staffing industry. Concentric exhibits a passion for partnering with our clients to become an integral part of their staffing solution.
Concentric is currently looking for a skilled Care Coordinator!
JOB SUMMARY
Conducts Medical / Surgical or Behavioral Health medical necessity reviews for continued stay reviews, care coordination, discharge planning, and post-nursing calls.  Conducts review and pre-screening reviews for Medical Director prior to non-certification.   Initiates discharge-planning care coordination and post-service nursing calls. Utilizes clinical and analytical skills to identify and refers cases to Case Management or Disease Management as appropriate.  Provides support to non-clinical staff on clinical and coding questions.  Conducts pre-admission screening assessments.
 
KEY RESPONSIBILITIES
Coordinates discharge planning, completes necessary authorizations, and conducts post-service nursing calls.
Conducts Utilization Management continued stay and inpatient reviews to assess medical necessity.
Researches and collaborates with appropriate community resources to support discharged beneficiaries.
Prepares more complex cases for Medical Director and Peer Review.  Collaborates with Medical Director on decision-making.
Utilizes clinical and analytical skills to identify and refers cases to Case Management or Disease Management as appropriate.
Communicates with providers to develop plan of care.
Conducts complex authorizations for beneficiaries in acute, residential treatment center, skilled nursing facilities, or long-term acute care hospitals.
Identifies and reports potential quality or fraudulent cases to Internal Audit & Corporate Compliance department or Clinical Quality Management for review.
Participates in focus group studies as requested, including the development and implementation steps.
Supports other regional hubs as needed.
Perform other duties as assigned.
Regular and reliable attendance is required.
WORKING CONDITIONS
Availability to work any shift
Works within a standard office environment, with minimal travel
Extensive computer work with prolonged sitting
REQUIRED EDUCATION & EXPERIENCE
Registered Nurse, Licensed Clinical Social Worker, or Licensed Clinical Psychologist (Ph.D./Psy.D.); MUST have current unrestricted license in Arizona 
2+ years experience in Medical / Surgical clinical nursing OR 2+ years Behavioral Health experience in inpatient or outpatient setting
Proficiency in medical data entry and Microsoft Word
Exceptional oral communication skills
PREFERRED EDUCATION & EXPERIENCE
5 years Medical/Surgical clinical nursing OR knowledge of Behavioral Health Levels of Care
2+ years Managed Care experience  
Knowledge of: Intensity of Service and Severity of Illness indexes; InterQual Imaging Criteria, Procedural Criteria, Level of Care, and Length of Stay; International Classification of Diseases; Current Procedural Terminology; and Health Care Financing Administration Common Procedure Coding System; and American Dental coding