Registered Nurse Care Coordinator

2 months ago

Taylor, United States The Information Center, Inc. Full time
Job Overview

Salary: Competitive

GENERAL SUMMARY

Under the supervision of the CMD Manager, the RN Care Coordinator employs person-centered methodologies to evaluate the medical, functional, psychological, financial, and environmental requirements of MI Choice Medicaid Waiver participants. Initial training will be conducted in-person, transitioning to a hybrid model upon successful completion of training and compliance with all policy and performance standards.

KEY RESPONSIBILITIES

  • Conduct comprehensive in-home evaluations to pinpoint areas of need and service preferences, including the assessment of service frequency and duration as outlined in the care plan.
  • Review participant medications and identify potential interactions or issues.
  • Assess disease progressions to collaborate effectively with external entities (e.g., hospice, skilled nursing, community mental health services) to enhance participant independence.
  • Identify and address potential health care issues, including nutrition, hydration, and physical conditions.
  • Collaborate with physicians, LPNs, and other medical professionals to determine optimal treatment plans for participants.
  • Provide education and resources to participants and their families regarding treatment options in the home setting.
  • Collect and synthesize information from diverse sources, including participant self-reports, family feedback, and documented medical histories.
  • Utilize motivational interviewing techniques to evaluate and articulate participant motivations for addressing identified needs.
  • Manage a caseload to ensure timely completion of assessments, documentation, and reporting.
  • Work alongside the Community Resources Department to provide accurate information about available services and supports.
  • Assist in developing comprehensive Individualized Person-Centered Service Plans in collaboration with participants and their support systems.
  • Conduct collaborative in-home reassessments as part of an RN/SW team, ensuring thorough documentation of service needs and preferences.
  • Document all service activities and communications related to program participants in accordance with contractual obligations.
  • Connect participants with community services and supports based on their Individualized Person-Centered Service Plans.
  • Engage in regular clinical supervision, case consultations, and professional development sessions to enhance resource utilization for growth.
  • Adhere to established productivity standards and comply with all program guidelines.
  • Participate in outreach and enrollment initiatives for the Waiver program.
  • Maintain valid state licensure and fulfill all licensure requirements.
  • Uphold professional ethics and boundaries in all interactions.
  • Follow agency and departmental policies and procedures.
  • Perform additional duties as assigned.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES

The ideal candidate must possess the ability to:

  • Engage with community members from diverse backgrounds.
  • Collaborate effectively with supervisors, colleagues, and agency staff.
  • Embrace supervision and demonstrate a commitment to personal and professional development.
  • Exhibit dedication to the welfare of the elderly and adults with disabilities served by the program.
  • Work independently in a community-based environment with minimal supervision.
  • Demonstrate proficiency in computer applications, including Word, Excel, and Outlook.
  • Contribute positively as a team member.
  • Represent the agency professionally in all interactions.
  • Manage crisis situations effectively.
  • Possess a valid Michigan Driver's License and reliable transportation for travel within designated regions.

EDUCATION AND EXPERIENCE

  • Current Registered Nurse license in the State of Michigan is required.
  • Preferred: Two years of experience in a hospital, home care, or community-based setting.

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