Job Title: Remote Clinical Care Coordinator (RN)
Position Type: Full-time
Work Schedule: 8:30 AM – 5:30 PM Pacific Daylight Time
Salary: $6–$7 per hour (depending on experience)
Preferred Candidate Location: Philippines
About Our Client
Our Client is looking for a highly skilled Remote Clinical Care Coordinator (RN) to support referral intake, clinical review, discharge coordination, and proactive patient follow-up within a home health environment.
This role functions as a clinical liaison and operational lead for referral intake, eligibility determination, risk stratification, and care coordination, helping ensure patients receive safe and appropriate care while reducing avoidable hospital readmissions.
The ideal candidate is a confident clinical professional who can assess patient needs, identify potential complications, and coordinate effectively with physicians, hospitals, clinicians, and patients.
Key Responsibilities
Referral Intake & Clinical Review
Receive, log, and triage referrals from hospitals, skilled nursing facilities (SNFs), physicians, and community partners.
Review clinical documentation such as H&P, discharge summaries, therapy notes, progress notes, and physician orders to ensure accuracy and completeness.
Communicate with referral sources to obtain missing documentation or clarify clinical needs
Determine whether patients are appropriate for home health services based on clinical risk and operational capacity.
Eligibility Screening for Home Health Services
Screen referrals to ensure patients meet home health eligibility requirements, including homebound status, skilled nursing or therapy needs, and physician oversight with valid orders.
Verify insurance coverage such as Medicare, Medicare Advantage, Medicaid, and commercial plans.
Confirm service area coverage and staffing availability before patient acceptance.
Clinical Risk Stratification & Acuity Assessment
Assess the risk of hospital readmission and identify high-risk patients based on factors such as recent hospitalizations or SNF stays, multiple or unstable comorbidities, polypharmacy or complex medication regimens, and limited caregiver support or other social risk factors.
Escalate high-risk cases to clinical leadership when necessary.
Identification of Clinical Complications
Screen referrals for high-acuity needs such as complex wounds or infection risks, IV therapy including PICC or central line care, enteral feeding tubes (NG, G-tube, or J-tube), catheter or ostomy management, and respiratory support such as oxygen therapy, tracheostomy, or ventilator care.
Ensure patient acuity aligns with available nursing competencies.
Care Coordination & Collaboration
Coordinate with the Clinical Manager and care teams regarding care coordination meetings, high-risk patient discussions, and the escalation of clinical concerns.
Provide clear clinical handoffs to field nurses, schedulers, and care teams.
Hospital & Referral Partner Communication
Serve as a primary clinical contact for hospitals and skilled nursing facilities.
Send reports and updates regarding admissions, care delays, and discharge planning when required.
Maintain accurate reporting records and documentation.
Patient Tuck-In Calls & Readmission Prevention
Conduct weekly tuck-in calls every Thursday and Friday to check patient status before the weekend.
Identify red flags such as symptom changes, medication issues, wound concerns, or caregiver challenges.
Escalate concerns that may require weekend nursing visits, therapy intervention, physician communication, or care plan adjustments.
Document findings to support proactive readmission prevention.
EHR System:
Kinnser
Requirements
Professional & Clinical Requirements
Registered Nurse (RN) or strong clinical background required
Relevant medical degree or nursing education required
Active nursing license preferred
Experience in home care or home health is strongly preferred
Strong clinical judgment for referral review, patient triage, and discharge…