Clinical Care Coordinator

4 days ago


GondrecourtleChâteau, Grand Est, United States Allina Health Full time
Job Summary

Allina Health is a not-for-profit health system dedicated to providing exceptional care to individuals, families, and communities in Minnesota and western Wisconsin. Our mission is to prevent illness, restore health, and provide comfort to all who entrust us with their care. We prioritize whole person care, investing in the well-being of our patients and enriching their careers.

Key Position Details
  • Tier 1: 3 years recent RN nursing experience, 2 years equivalent full-time acute care, and 2 years RNCC experience required.
  • Tier 2: 3 years recent RN nursing experience, 2 years equivalent full-time acute care, and 1 year RNCC experience required.
  • Tier 3: 3 years recent RN nursing experience, 2 years equivalent full-time acute care required.
  • 1.0 FTE (80-hours per two-week period)
  • Day, 8-hour shifts (07:30 AM-04:00 PM or 08:00 AM-04:30 PM)
  • Every 4th weekend rotation
  • MNA-represented, benefit-eligible position
Job Description

As a Clinical Care Coordinator - RN, you will provide clinical coordination services, including assessment, planning, and intervention. You will identify patients through predictive tools and referrals from providers, staff, or community caregivers to facilitate clinical transition planning for medically complex patients from the hospital when medically indicated. You may also provide initial and concurrent level of care review and insurance authorization activities.

  • Supports progression of care for complex patients.
    • Completes clinical assessments and participates in patient care rounds to ensure critical interventions and procedures are completed to achieve optimal patient outcomes.
    • Ensures timely progression of care with proactive identification and elimination of potential delays/barriers in patient care. Escalates barriers to leadership for resolution.
    • Collaborates with healthcare team, community care providers, patients, and families to ensure effective clinical and timely transition of care.
    • Provides information and supports activities related to palliative care and advanced care planning to patients and families experiencing chronic disease progression.
    • Provides age-appropriate patient care based on population served.
  • Coordinates appropriate clinical transition of patients in the hospital and Emergency Department.
    • Collaborates with interdisciplinary team to plan anticipated transfer or discharge.
    • Serves as subject matter expert with high knowledge base of integrated, seamless post-discharge care and services offered by the system.
    • Assesses clinical stability for discharge and oversees clinical details of transitions.
    • Ensures accurate and complete discharge orders.
    • Identifies patients and families with complex discharge issues, rehab services for functional issues to prepare patients for internal or external transitions.
    • Conducts screening or assessment tests to select patients and communicates the need for follow-up with community resources in collaboration with provider.
  • Participates in care system processes that prevent potentially preventable readmissions.
    • Plans and participates in transition conferences with patients and families.
    • Utilizes tools and technology to identify and intervene with patients who are at risk for readmission.
    • Ensures that a complete clinical handoff occurs for at-risk patients, which may include referrals.
  • Collaborates with healthcare team to promote appropriate length of stay.
    • Utilizes tools and technology to support appropriate length of stay management.
    • Facilitates timely referrals and transfers of information.
    • Ensures outpatient complex clinical care services are in place at the time of discharge along with other complex clinical care needs.
  • Demonstrates appropriate clinical resource management and adherence to commercial and regulatory requirements.
    • Supports level of care activities, including the use of established inpatient guidelines and internal and external utilization criteria.
    • Collaborates with Social Workers to identify trends or concerns related to reimbursement and discharge planning.
    • Ensures timely interventions for patients who are admitted under observation status.
    • Provides information and assistance for identified financial or social needs.
    • Maintains knowledge of government and private payer networks and services.
    • Collaborates with community and healthcare resources based on need to coordinate care for the patient.
  • Other duties as assigned.

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