Clinical Care Coordinator
2 weeks ago
Position Overview:
The Clinical Care Coordinator is responsible for the integration and coordination of clinical services for patients. This role involves facilitating a comprehensive interdisciplinary care plan to address various service requirements, ensuring continuity of care while minimizing fragmentation, and optimizing resource utilization. The Coordinator acts as an educator and serves as a primary communication link for patients and their support networks.
Qualifications:
CERTIFICATION & LICENSURE REQUIREMENTS
Must possess a Registered Professional Nurse (RN) License in the state of Illinois upon hiring.
ADDITIONAL REQUIREMENTS
- Proficient use of standard equipment necessary for performing essential job functions.
- Occasional travel to various healthcare facilities may be required.
- Must have a valid driver's license and be able to drive for business purposes.
Proficient in reading, writing, and speaking fluent English. Basic computer skills, including familiarity with word processing, spreadsheets, email, and web browsing.
Key Responsibilities:
- Care Coordination: Conducts comprehensive screenings for all adult Medical Surgical inpatients and assesses their health status, including clinical conditions and support systems, to identify needs and make appropriate referrals to multidisciplinary services. Prioritizes patients for care coordination based on established criteria. Monitors and coordinates an interdisciplinary care plan in collaboration with patients and their support systems, ensuring effective transitions across various levels of care. Responsible for developing and implementing discharge plans for complex care patients, working with both internal and external resources to ensure safe transitions. Engages with the interdisciplinary team during daily rounds to plan, deliver, and evaluate patient-centered care. Maintains accurate documentation of the case management plan, addressing clinical needs, barriers to quality care, and resource utilization.
- Discharge Planning: Collaborates with patients, caregivers, and healthcare providers to ensure safe discharge planning. Identifies and facilitates post-acute resource needs, including home care, community referrals, and outpatient therapies. Ensures that patient vulnerabilities are documented and communicated effectively to care managers. Reviews predictive tools for readmission risks and implements interventions to mitigate these risks.
- Patient Education: Identifies patient and family learning needs and collaborates with direct care nurses to develop educational plans. Refers to subject matter experts as necessary and documents education related to medication adherence and self-management.
- Revenue Cycle Management: Demonstrates knowledge of financial and reimbursement processes to support medical cost management. Acts as a resource for patients and families regarding financial aspects that may impact their care transitions.
Carle Health is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment based on race, color, sex, age, national origin, religion, sexual orientation, gender identity, veteran status, disability, or any other protected class. Carle Health participates in E-Verify to confirm work authorization.
COVID-19 Vaccination Requirement: Effective September 20, 2021, the COVID-19 vaccine is required for all new team members, with exemptions for medical or religious reasons permitted.
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