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Patient Care Coordinator
2 months ago
Job Overview
Insight Global is seeking a Patient Care Coordinator (RN) to enhance support for a healthcare facility. The Patient Care Coordinator operates under the guidance of the clinical management director, facilitating the coordination of care for patients to ensure safe, smooth, and timely transitions throughout their healthcare journey. By employing a collaborative approach, the coordinator will identify, assess, plan, implement, and evaluate the necessary options and services to address an individual's health and related needs, including social determinants impacting overall wellness.
Key Responsibilities:
- Recognize and prioritize patients requiring care coordination services, utilizing a comprehensive approach that considers biopsychosocial, functional, cultural, spiritual, and financial aspects; engage in a multidisciplinary strategy to assess and plan for care requirements.
- Implement strategies such as motivational interviewing to enhance patient engagement, self-management, adherence to treatment, and optimal health outcomes.
- Apply evidence-based guidelines (e.g., InterQual) to ensure quality care, reduce variability, and minimize waste. Confirm appropriate levels of care; document actions to prevent denied days; refer cases to the Physician Advisor as necessary.
- Proactively manage observation stay patients, ensuring timely testing, treatment, and appropriate transitions to inpatient status or discharge.
- Develop and coordinate transition plans for patients moving to home care, community care coordination programs, hospice, palliative care, home infusion, and skilled post-acute providers; ensure all necessary documentation and handovers are completed.
- Maintain precise documentation in each patient record to reflect physical and functional limitations, psychosocial characteristics, educational needs of patients and families, and transition requirements. Initiate referrals to other disciplines as needed.
- Participate in clinical outcome projects and process improvement initiatives within the care management department.
- Identify patient situations requiring referral to other healthcare team members, such as infection control or quality management, ensuring that care plans are adjusted as necessary and follow-up occurs.
- Utilize risk and predictive analytic tools to apply tailored interventions that address potential barriers or risks, unnecessary hospitalizations, and readmission prevention.
- Ensure compliance with all regulatory standards (CMS, commercial insurers, etc.).
Additional Information:
*Candidates must be non-smokers (drug testing will include nicotine).
We are dedicated to fostering diverse and inclusive environments where individuals can express their authentic selves at work. We are an equal opportunity/affirmative action employer that values every individual. Qualified candidates will be considered for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.
Qualifications:
Current licensure as a registered nurse.
BSN or ADN with equivalent experience (BSN must be obtained within five years of starting the role).
Minimum of 2 years' experience in a clinical setting, preferably with care coordination experience.
