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Care Coordinator, RN/LPN

1 month ago

Framingham, Massachusetts, United States Whittier Health Network Full time
Job Summary

We are seeking a skilled and compassionate Care Coordinator, RN/LPN to join our team at Whittier Health Network. This is a full-time position, 40 hours/week, with all shifts available.

Job Description

The Care Coordinator, RN/LPN will provide exceptional care to all residents, including but not limited to:

  • Coordinates and oversees each Medicare and Managed Care patient's care from admissions through post-discharge follow-up
  • Maintains communication between the interdisciplinary team, patient/family, and external case managers from payors or other facilities
  • Continuously monitors documentation to meet guidelines or standards developed by regulatory agencies
  • Services as a reimbursement specialist and resource person
  • Participates in admission process and admission meetings, reviews screen referrals
  • Begins assessment of discharge planning needs on admission
  • Develops pre-admission treatment plan as required, to include specific objectives, goals, and interventions
  • Implements and reviews treatment plan and length of stay in accordance with predetermined criteria
  • Evaluates, assesses, and modifies the plan as needed throughout the stay, including nursing and rehab services
  • Coordinates, monitors, and documents overall progress toward stated goals as needed
  • Communicates with patient and/or family regarding plan of care, discharge planning, and reimbursement issues
  • Communicates verbally, via telephone, in writing, and/or via fax with payor/external case managers regarding progress, changes in patient condition, and plan modifications, advocating services at an appropriate intensity to best meet the patient's needs
  • Obtains authorization for continued stay
  • Obtains authorization and approvals as needed regarding coverage for third-party payors, extra-contractual services, or recommended treatment plans
  • May coordinate and provide termination of benefits letters provided by payor/external case managers
  • Responsible for ongoing management of discharge planning in collaboration with Social Services
  • Coordinates clinical discharge summaries with nursing staff
  • Attends interdisciplinary team meetings weekly and as needed
  • Evaluates and makes adjustments to the overall plan as needed
  • Attends family conferences where information relating to the status of the patient's progress is discussed as needed
  • Coordinates and attends team rounds weekly
  • Coordinates through Central Supply equipment ordering/specialized mattress ordering and sign-off as required
  • Communicates to billing medical records and rehab all level changes
  • Follows up on billing issues as needed
  • Conducts/attends regularly scheduled staff meetings when required
  • Coordinates services rendered by nursing personnel with those rendered by personnel of other departments
  • Accurately documents all case management activities in the patient's medical record
  • Reviews medical record documentation and monitors for compliance per facility policy and regulatory agency requirements for all departments
  • Assists in completion of MDS process, as needed
Requirements
  • Graduate of an accredited Registered Nurse school of nursing
  • Current and active RN or LPN license in the state of Massachusetts
  • Current certification in Basic Cardiac Life Support in accordance with AHS or ARC standards
  • Minimum of five (5) years recent clinical experience, preferably in long-term care
  • Effective written and verbal communication skills
  • Prior Utilization Review and/or Case Management experience required
Benefits
  • 401(k)
  • Paid Sick
  • Paid Vacation
  • Paid Holiday
  • Medical
  • Dental
  • Vision
  • Life
  • Short and Long Term Disability
  • Hospital and Accident policy
  • Critical Illness
  • Christmas Club
  • Flexible Spending Accounts
  • Health Savings Account