Nurse Care Coordinator
7 days ago
About the Role: Community Health Systems is seeking a skilled Nurse Care Coordinator to join our team in providing high-quality care coordination services to our members.
Job Summary: As a Nurse Care Coordinator, you will play a critical role in ensuring seamless transitions of care for our members. You will work closely with healthcare providers, facilities, and community resources to develop and implement individualized care plans that meet the unique needs of each member.
Main Responsibilities:
- Conduct thorough discharge risk assessments to identify potential complications and develop strategies to mitigate them.
- Lead and conduct discharge summaries to assess medical necessity, service appropriateness, and level of care, utilizing evidence-based criteria.
- Ensure timely completion of documents per regulatory requirements and maintain accurate records.
- Serve as a liaison between hospitals, MCPs, vendors, outside agencies, and providers to ensure effective communication and collaboration to meet member treatment plans and goals.
- Collaborate with the Transition of Care Community Health Worker to confirm timely arrangements for post-discharge services, including appointments, referrals, DME, transportation, and medication reconciliations.
- Provide guidance to members to touch base with their primary care physician and medical care team for follow-up questions or concerns.
- Maintain a high standard of professionalism, ethics, and conduct in all aspects of the role, including speech, manner, attitude, and appearance.
- Participate in staff meetings, trainings, committee meetings, and other activities as directed by CHSI and Managed Care Plans.
Requirements:
- RN unrestricted license required.
- A valid California driver's license, a reliable car, and valid automobile insurance are also required.
- Three (3) or more years of care management experience in a healthcare delivery setting preferred.
- Experience in a Health Care Organization or experience in Managed Care setting preferred.
- American Heart Association BLS certification required.
Salary: $85,000 - $110,000 per year, depending on experience.
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