Care Coordinator-RN

1 week ago


Shelton, United States Mason Health Full time

Care Coordinator RN: This 0.5FTE/Part-time position is scheduled to work variable 10-HR day shifts. Compensation: Non-exempt, $46.32/HR-$67.29/HR Benefits: Mason Health provides an excellent benefit package to Part-time and Full-time employees, including: Medical, Dental & Vision Insurance Retirement/ Deferred Compensation plans Mason Health will make employer contributions of 8% of your compensation for each pay period that you contribute at least 5% of your compensation. Paid Time Off, accrue up to 8 hours of PTO per bi-weekly pay period Life Insurance Employee Assistance Program Mental Health & Wellness resources Tuition Assistance Program Optional or elective benefits include: Flexible Spending Account Short & Long term disability insurance Job Summary: The RN Care Coordinator coordinates and directs team based care to establish partnerships with patients, families, support systems, and other providers to reach a shared goal that is focused on the promotion and maintenance of health and the prevention or resolution of disease, illness or disability. Facilities a healthcare delivery model within and across settings in order to provide high quality care coordination that is focused on preservation and restoration of health. Responsible and accountable for direct and indirect patient care across the care continuum; providing support and guidance to other staff in the management of the patient as well as taking an active role in care. Job Specific Duties & Responsibilities: Performs a comprehensive assessment and evaluates assigned patients to establish a goal oriented treatment plan, analyzing data from a variety of sources such as patient records, interviews, observation, and team members. Coordinates team based care through effective partnerships with patients, their caregivers, and their providers. Evaluates outcomes and adjusts the care plan as needed. Identifies barriers (eg. Psychosocial, literacy, financial, cultural) to effectively communicate and make appropriate changes. Communicates effectively with primary care providers, hospitals, specialists and post-acute care facilities to schedule appointments and identify and fill gaps of care; facilitates access to appropriate primary and specialty providers as well as other care coordination team support specialists (e.g. Diabetes Educators, Registered Dieticians and Patient Resources).Evaluates and modifies plans of care as needed. May provide ongoing follow up between hospitalizations/clinic visits. Monitors patient progress toward established goals. Acts as a hospital liaison for families and external agencies and individuals providing services to the patient. Provides a coordinated strategic approach to detect and effectively manage patients with chronic disease, complex and challenging conditions. Establishes an effective tracking system for identified patients. Coaches patients/families toward successful self-management of chronic disease (CDSMP). Participates in chronic disease self-management educational programs. Develops "best practice' recommendations by partnering with evidenced based authoritative resources. Promotes improvements in nursing practice through membership and leadership in professional organizations, in Mason Health committees, and utilization of current research. Participates in ACO/care coordination meetings and training opportunities. Actively develops and maintains professional and clinical skills. Participates in staff meetings, patient care meetings, educational in-services and other professional activities. Maintains awareness of policies and procedures and performance standards. Identifies potential Quality Improvement initiatives. Other duties as assigned. Required Education and Experience: Associate's degree in Nursing, or equivalent, required. Bachelor's degree preferred. Two (2) years of experience coordinating care for patients with chronic diseases. Experience mobilizing community resources, navigating through the healthcare continuum and working with disparate populations preferred. Required Licenses, Certifications and/or Registrations: Current RN license in the state of Washington Current Basic Life Support (BLS) certification required within 3 years of hire. Successful completion of Chronic Disease Self-Management (CDSMP) program required within 1 year of hire ANCC Nursing Case Management board certification (RN-BC) or ACMA Accredited Case Manager (ACM) certification


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