RN Care Coordinator
4 days ago
Savista is seeking a skilled RN Care Coordinator to join our team. As a key member of our healthcare team, you will play a vital role in ensuring seamless transitions of care for our patients.
Key Responsibilities- Screen patients for clinical, psychosocial, financial, and other factors that may impact care progression and collaborate with patients/families/caregivers to set goals that reflect their needs.
- Evaluate patients'/families'/caregivers' level of understanding and engagement with progress toward goals and incorporate findings into the plan of care.
- Arrange services among community agencies, providers, patients/families/caregivers, and others involved in the plan of care.
- Provide patients/families/caregivers with available tools/resources, including pertinent quality measures, to make informed choices.
- Develop an appropriate plan that focuses on patients' needs, goals of care, and treatment plan, consistent with patient choice and available resources.
- Facilitate bi-directional communication to enhance handover of care from one setting and ensure all elements of transition plan are implemented and communicated to key stakeholders.
- Identify available community resources/potential partners and advocate for resolution of gaps in available resources and processes.
- Maintain knowledge of and ensure compliance with federal, state, and local organization and accreditation requirements that impact scope of services and ability to advocate for patients.
- Ensure patients are in appropriate status, level of care, and length of stay for their clinical condition and participate in multidisciplinary rounds with care team.
- Follow through with appropriate intervention and documentation to facilitate discharge when a patient fails to meet medical necessity.
- Identify and address discharge delays and practice patterns that may require modification to support cost-effective care.
- Educate patients/families/caregivers on financial impact of their care options.
- Track discharge delays as well as over/under utilization of resources.
- Participate in development of performance improvement activities relevant to identified opportunities.
- Recognize situations that require referral to quality or risk management and make timely referral.
- Delegate appropriate tasks within care coordination team.
- Bachelor's Degree required. BSN preferred.
- Licensed as a Registered Nurse in the state of Florida required.
- Minimum of 3-5 years discharge planning, case management, managed care, or Registered Nurse experience in a medical setting preferred.
- Case Management Certification preferred.
Savista is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity, or any other federal, state, or local protected class.
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