Professional functions of Care-Coordinator

1. Proactively develop case management plans that address the individual enrollee/member/ client/patient's physical and psychosocial needs to ensure appropriate treatment, protocols and delivery system, and Payor authorization, when necessary.2. Assess changing enrollee/member/client/patient needs utilizing the knowledge and skills necessary to provide continuity of appropriate care to enrollees/members/clients/patients and address deviations between requested and approved plans with the practitioner.3. Identify cases with potential high-risk complications and act as an advocate for the individual's health care needs.4. Researches disease and case management literature.5. Audits charts for quality indicators.6. Accesses records for ROI.7. Evaluate the appropriate length of stay (LOS), level of service and site of care.8. Negotiate preferential rates with selected providers, when appropriate.9. Assure that all enrollees/members/clients/patients are treated with respect and consideration, that their right to treatment or service is respected, that confidentiality, privacy and security are maintained, and that they are involved in all aspects of their care.10. Maintain confidentiality, security and integrity of data and information.11. Maintain departmental accuracy standards.12. Maintain enrollee/member/client/patient and provider satisfaction of 90% "good" or above.13. Work collaboratively with other case management team members and support staff.14. Perform other related duties as assigned.