About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
The Inpatient Care Coordinator will follow Fallon Health members in the inpatient setting using established business guidelines and with oversight from an UM Nurse.
Ensure accurate and timely data entry in the case management software system.
Effectively communicate with nurses, service coordinators, authoriztion Coordinators and vendors as necessary.
Manage uncomplicated members in DRG facilities under the oversight of the UM Nurse.
Maintain the Memorial Hospital NICU census and enter clinical review of babies under the oversight from the assigned UM Nurse
Education, Licenses, certification and experience requirements:
Education: College degree or equivalent preferred
License: Current MA Drivers License
Experience: 1-3 years job experience in a medical related field or with a healthcare payor company. Experience in a healthcare payor company a plus