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Nurse Care Coordinator

2 months ago

Edgewater, New Jersey, United States VNS Health Full time
About the Role

VNS Health is seeking a skilled Nurse Care Coordinator to join our team. As a key member of our clinical services team, you will play a vital role in coordinating and overseeing the delivery of high-quality, cost-effective care to our patients.

Key Responsibilities
  • Coordinate and/or oversee the coordination of benefits and services for all patients on your caseload.
  • Complete comprehensive care management and disease-specific assessments to identify patient needs and develop personalized care plans.
  • Make timely telephonic care management calls to patients based on risk level, ensuring timely interventions and optimal outcomes.
  • Resolve and coordinate complex issues and patient complaints impacting the delivery of services, providing exceptional customer service and ensuring patient satisfaction.
  • Provide health education to patients and caregivers, empowering them to take an active role in their care and well-being.
  • Assess social determinants of health and provide care coordination to reduce or remove barriers to care, ensuring seamless transitions and optimal patient outcomes.
  • Identify patient safety issues and intervene as necessary, referring to appropriate resources and community linkages to ensure patient well-being.
  • Coordinate the delivery of high-quality, cost-effective care based on a customized population model of care, supported by evidence-based clinical practice guidelines.
  • Advocate for patients and caregivers to obtain the healthcare and other services needed to optimize their quality of life.
  • Utilize the care management process to set priorities, plan, organize, and implement interventions that are goal-directed towards self-care outcomes and the transition to independent status.
  • Promote adherence to physician treatment plans by providing education, coaching, and support, ensuring optimal patient outcomes.
  • Reduce inappropriate utilization of emergency room and hospital services by educating, coordinating, and providing resources to patients and caregivers.
  • Increase utilization of primary care, specialty care, preventive health, and guideline-based treatments, including proper pharmacotherapy within network, as appropriate.
  • Participate in interdisciplinary team meetings and provide input on customer service-related activities, ensuring seamless communication and collaboration.
  • Protect the confidentiality of patient information and adhere to company policies regarding confidentiality, ensuring the highest standards of patient care and trust.
  • Ensure compliance with payors' policies and procedures, as well as all Federal and State regulations, maintaining the highest standards of patient care and regulatory compliance.
  • Interpret and implement VNS Health policies, state, and federal regulations, ensuring seamless integration and optimal patient outcomes.
Requirements
  • Associated degree in nursing or a bachelor's degree in physical therapy required.
  • Minimum two years of experience as a registered nurse.
  • License and current registration to practice as a Registered Professional Nurse or Physical Therapist or Occupational Therapist in the State of New York required.
  • Population Care Coordination Certification preferred.
  • Care Management, Case Management, OASIS, or other application certification preferred.