RN Care Coordinator

2 months ago

Kingston NY Ulster County NY New York State United States WMCHealth Full time

Provides care management and care coordination for patients receiving treatment and follow up as needed. Serves in an expanded health care role to collaborate with other clinicians and members of the healthcare team as necessary to ensure the delivery of efficient and cost effective healthcare services. Integrates evidence-based clinical and preventative guidelines in development of patient centered tools to assist patient in decision making that benefits their optimal health. Provide targeted interventions to avoid unnecessary hospitalizations and emergency room visits.
Employee completes annual Mandatory Education Module, Annual Health Assessment, Age Specific requirements, etc… (Time and Attendance: Employee complies with all HealthAlliance and departmental policies for time and attendance.
Professional Appearance: Employee complies with HealthAlliance policy for professional Appearance (Dress Code), including wearing ID Badge.
Maintains familiarity with the laws, regulations, and interpretation of utilization review and discharge planning. Remains up to date on changes in regulations, policies and procedures. Incorporates the highest standard of professional, clinical, legal, and ethical practice (i.e., Conducts ongoing quality monitoring including identification of quality, risk management and infection control issues and reports them to the Director of the appropriate department. Explores strategies to reduce the length of stay and resource consumption within the case managed populations, implement them and document the results.

 
~ Incorporates knowledge of clinical expertise, quality, insurance and finance into decision making and problem solving regarding patient management. Assesses the patients within the caseload to identify needs, issues, resource, care goals, discharge needs and beyond if necessary. Provides utilization review in the Emergency Department as needed. Facilitates a multidisciplinary patient review in concert with RNs on the unit to ensure comprehensive plan of care is followed.

 
~ Plans the patient's care collaboration with the health care team patient/family for the hospital stay. Communicates continually with physicians, providing information and interpretation of third party payer guidelines and assists in securing timely referrals to achieve clinical, utilization and financial objectives. Confers with the attending physician to determine medical necessary for admission or continued stay, when necessary. Convenes and chairs multidisciplinary care conferences for patients readmitted within 30 days for any reason to evaluate the cause and plan/implement corrective actions; Coordinate the care of patients whose care is at risk from either a clinical or cost perspective. Promotes a timely, cost effective, efficient and safe discharge plan to community services including extended care, acute rehabilitation, sub-acute care, long-term care, or home health services. Collaborates with other departments within the outside the hospital as necessary (especially admitting, billing office, fiscal, managed care, insurance case managers, finance) and the screeners.

 
~ Works as part of fluid team to collaboratively meet the needs of patient population and healthcare organization.

 
~ Able to adapt to changing workflow as projects arise.

 
RN, Graduate of an accredited school of Nursing or BSW/CSW (BSW minimum) or Masters in another health related field. 2 years hospital based. Knowledge of medical/surgical cases. Training/License:
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