Managed care coordinator vs assistant director of nursing

Differences between managed care coordinator and assistant director of nursing duties and responsibilities

Managed care coordinator example responsibilities.

• Manage ICD-9 coding and DRG validation for high volume of claims.
• Ensure all clinical operations comply with Medicare and Medicaid guidelines and other manage care policies.
• Manage caseload by providing care coordination to individuals with a primary intellectual/developmental disability diagnosis all of whom receive community-base waiver services.
• Adhere to all state, accreditation standards and regulatory guidelines which include HIPAA guidelines and NCQA accreditation.
• Enter and approve authorizations for patients being discharge from hospitals to a sub- acute rehabilitation facility or a skil nursing facility.
• Review ICD-9 and HCPCS codes to insure proper coding used on claims.
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Assistant director of nursing example responsibilities.

• Manage care for all residents, ICF and SNF.
• Evaluate operational performance consistently achieving excellent JCAHO accreditation.
• Assist with managing daily facility operations, including patient care, staff supervision and logistical oversight.
• Work to ensure regulatory compliance by conduction mock surveys, interviewing patients and randomly assessing medical records.
• Complete newly-required HCFA MDS, and coordinated/chair all interdisciplinary care plan meetings to maintain HCFA regulatory compliance.
• Administer BLS training for license staff.
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