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Registered Nurse Care Coordinator PRN
2 months ago
Position Overview:
The Registered Nurse Care Coordinator collaborates effectively with physicians and various healthcare professionals to enhance the well-being of patients facing chronic illnesses or intricate health challenges.
This role involves educating patients and their families to empower them in managing their healthcare requirements.The incumbent plays a crucial role in facilitating communication, coordinating services, addressing obstacles, and optimizing resource allocation while ensuring a balance between clinical excellence and cost efficiency.
Key Responsibilities:
As a Registered Nurse Care Coordinator, your expertise will include:
- Conducting thorough assessments of patients' health needs, encompassing health status, behaviors, functional levels, psychosocial circumstances, and available support systems to identify potential requirements.
- Collaborating with primary care physicians and the patient care team to establish comprehensive care plans.
- Providing essential health education to patients and families.
- Identifying at-risk patients for proactive interventions.
- Utilizing data analytics to pinpoint at-risk patients and presenting findings to the care team.
Additionally, you will:
- Refer patients to various resources, including nutrition, social work, rehabilitation, behavioral specialists, diabetes education, and wellness workshops.
- Engage with patients who have utilized emergency services or have been hospitalized post-discharge to understand the reasons for their visits and collaborate with them to create plans to prevent future occurrences.
- Coordinate care for complex cases or patients consulting multiple specialists.
- Maintain accurate and current documentation of patient assessments and care plans to ensure effective information integration for the healthcare team, promoting ongoing quality of care in line with evidence-based practices.
- Analyze patient care trends and actively collaborate with the care team to enhance overall care quality and efficiency.
- Utilize registry data to identify service gaps and initiate interventions.
- Demonstrate critical thinking for problem-solving and prioritization.
- Lead patient care conferences and manage patient panels with physician office staff to identify suitable patients and measure outcomes.
- Advocate proactively for patient care issues to ensure that the quality and type of care are tailored to each patient's and family's unique needs.
- Collaborate with payers and external agencies to promote a patient-centered care delivery model.
- Participate in committees and initiatives related to the development of Medical Homes, Accountable Care Organizations (ACOs), and other insurance partnerships.
Minimum requirements include a Bachelor's Degree (BS/BA/BSN) and a current RN license in the state of practice, along with a minimum of two (2) years of clinical experience in an outpatient environment or equivalent experience in coaching individuals with complex or chronic conditions.
Preferred Qualifications:Prior experience in care coordination within a community setting or primary care practice, along with program development, operations management, or supervisory experience is advantageous.
Physical Requirements:
Physical demands include the ongoing need to see and read information, assess patient needs, operate monitors, and identify equipment and supplies.
Frequent interactions with patients, care providers, and visitors necessitate effective verbal communication and the ability to quickly and accurately comprehend spoken information, particularly in emergency situations.
Manual dexterity is required for the manipulation of complex and delicate equipment with precision, including frequent computer use for documenting patient care and accessing necessary information.
