Clinical Services Coordinator

• Assist the Associate Director of Health with duties that include prioritize and assign work, provide input for performance evaluations, ensure staff are trained and follow policies and procedures, maintain a healthy and safe working environment, and if directed provide staff supervision.
• Process and coordinate medical referrals for the Phoenix Indian Medical Center (PIMC) to provide healthcare for tribal members in Maricopa County by scheduling appointments, generating purchase orders and explaining procedures.
• Review medical referrals and claims with assigned committee members; determine medical need, priority of request, eligibility, payer, and provide authorization of payment.
• Act as an advocate for patients and performs liaison activities between patients and healthcare providers; provide patient education about eligibility, diagnosis, and insurance.
• Work closely with the Native American Liaison for AHCCCS ensuring equal treatment for our tribal members.
• Monitor contractors to ensure they follow contract in providing health services to tribal members.
• Participate in discharge planning for patients to ensure appropriate services are in place and that the client is being discharged to an appropriate level of care.
• Perform other duties of a similar nature or level as requested by supervisor or director.

• Indian Health Service Programs, policies and procedures;
• Community health resources;
• Nursing practices and procedures;
• Medical terminology;
• Customer service principles;
• Regulations and procedures of hospitals or clinics as they relate to nursing services;
• Assess the necessity and urgency of requests for medical services to be provided to members in order to determine payment for the service;
• Monitor and report abnormal trends/variations in healthcare patterns;
• Promote excellence and professionalism in healthcare quality;
• ICD-9 and CPT coding guidelines;
• Resource and Patient Management System (RPMS) or similar patient information tracking system;
• Provide clinical review for all requests for home health and physical therapy, making appropriate assessments for approving payment for the service;
• Maintain a professional approach with confidentiality;
• Yaqui culture, customs, resources and traditions and/or a willingness to learn.

• Assess the necessity and urgency of requests for medical services to be provided to members in order to determine payment for the service;
• Identify issues and able to provide resolutions;
• Remain resourceful and calm in emergencies;
• Use computers and related software applications;
• Monitor and report abnormal trends/variations in healthcare patterns;
• Promote excellence and professionalism in healthcare quality;
• Provide clinical review for all requests for home health and physical therapy, making appropriate assessments for approving payment for the service;
• Maintain a professional approach with confidentiality;
• Operate a variety of office equipment, including a computer and related software applications;
• Good communication and interpersonal skills as applied to interaction with co-workers, supervisor, management, Council members, and the public. Have ability to sufficiently exchange or convey information and receive verbal and written work instructions.

• Must possess and maintain a valid Arizona Driver's License.

• Current licensed as a Registered Nurse issued by the Arizona State Board of Nursing.
• This position will require the incumbent to work non-traditional hours, nights, and weekends.
• Must have a current Level 1 Arizona Clearance Card or be able to obtain the Level 1 Arizona Clearance Card within ninety (90) days of hire. Failure to maintain a current Level 1 Clearance Card will result in termination from this position.

Pascua Yaqui Tribe