Registered Nurse Care Coordinator

2 weeks ago


Cleveland, Ohio, United States Cityblock Full time
Job Overview:
Position Summary:

The RN Care Coordinator (RNCC) is responsible for managing a diverse group of members, focusing on integrated care for chronic illnesses and mental health needs. The RNCC works closely with members to develop personalized care strategies and monitors their progress, continuously evaluating needs, collaborating with healthcare providers, and engaging with the Community Health Partner to foster trust and advocate for members.

Engagement Responsibilities:
  • Receive referrals from the engagement and care teams.
  • Communicate program expectations and objectives to members.
Assessment and Intake:
  • Administer self-efficacy and condition-specific assessments with members.
  • Utilize additional screening tools as necessary, including behavioral health assessments.
  • Identify members requiring behavioral health services.
  • Conduct in-person clinical evaluations when appropriate.
  • Collaborate with care team members to assess the need for program adjustments.
Case Review and Care Planning:
  • Prepare for and actively participate in case discussions, leading when necessary.
  • Collaborate with members to formulate care plans, addressing social needs with the Community Health Partner as required.
Clinical Interactions and Follow-Up:
  • Conduct regular follow-ups with members as per program guidelines.
  • Monitor therapeutic interventions from both internal and external providers.
  • Respond to member needs promptly and delegate tasks effectively.
  • Work collaboratively with a designated panel of members to provide comprehensive clinical support, including chronic disease management and psychiatric care.
  • Ensure proper documentation and coding to reflect quality care and gap closure.
  • Assist members in reaching their care plan objectives.
Operational Duties:
  • Utilize care facilitation tools, electronic health records, and scheduling systems to manage data, document interactions, and communicate with team members and community resources.
Qualifications:
  • Graduate from an accredited nursing program (R.N.).
  • Minimum of 3 years of relevant experience.
  • Basic Life Support (BLS) certification is mandatory.
  • Possess an active RN license in the practicing state(s) and an unrestricted driver's license.
  • Proficient in utilizing technology for remote member support.
  • Knowledgeable in scheduling systems for effective appointment management.
  • Experienced in electronic health record systems for accurate documentation.
  • Skilled in collecting and documenting member clinical and demographic information promptly.
  • Familiar with Motivational Interviewing and Trauma-Informed Care principles.
  • Strong problem-solving abilities and decision-making skills.
  • Creative in addressing challenges within the healthcare system.
  • Open to learning and adapting to new situations and priorities.
Diversity and Inclusion:
Cityblock values diversity and is committed to creating an inclusive environment for all employees. We are an equal opportunity employer, considering all qualified applicants without regard to race, religion, ethnicity, national origin, gender, gender identity, sexual orientation, age, veteran status, disability, or any other protected characteristic.

Health and Safety Notice:
Cityblock requires proof of COVID-19 vaccination for all employees in this role, with exemptions considered for valid medical or religious reasons.

Medical Clearance Requirements:
All member-facing roles must meet Cityblock's medical clearance standards, which may include proof of immunity to specific diseases or approved accommodations.

Recruitment Policy:
Cityblock does not accept unsolicited resumes from recruitment agencies.

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