Job TitleCASE COORDINATOR.Job FamilyFunctionCORP (SME: CFO-CPHO)Job Code30009338Reports to JobBusiness Unit LeadJob Description SummaryThe Case Coordinator independently handles daily operations for a designated patient caseload by assessing, planning, and facilitating the coordination of patient care and evaluates appropriateness of care utilizing evidence.-based tools to ensure smooth patient access and cost.-effective outcomes.Strategic Roles & Responsibilities %00Strategic Roles & ResponsibilitiesOperational Roles & Responsibilities %100Operational Roles & Responsibilities
Evaluate standard and routine requests from the various stakeholders based on patient benefits coverage agreements and medical necessity utilizing evidencebased tools to ensure patients receive quality costeffective care
Coordinate patient care to meet the individuals and their familys needs and ensure patient safety quality of care and costeffective outcomes
Coordinate processing of standard case review and documentation including logging tracking and resolution following established protocols and within defined service level agreements SLAs or provider contracts
Assist in maintaining uptodate patient documentation and periodic reporting ensuring information completed efficiently and accurately and is readily accessible for review and audits
Support the continuous patient care access and identifying and escalating anomalies to avoid patient care interruptions
Minimum Education RequiredBachelor's Degree in Nursing or Medicine.Professional Certifications RequiredRefer to applicable JD AddendumYears of Experience3.-5 years of of experience in relevant fieldLanguagesEnglish:Fully Proficient ; Arabic:Not RequiredFunctional Competencies
Due Diligence
Audit Reporting
Data Collection
Core Competencies
Excellence
Integrity
Accountability
Cybersecurity
Person-Centered Care
AcknowledgementPlease 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.Addendum TitleNoSupplemental Work/Experience/Education InformationN/AAddendum DescriptionN/A