Registered Nurse Care Coordinator
5 hours ago
The registered nurse is responsible for the planning, organization, and coordination of home health services, bringing a wealth of experience in nursing with a focus on community health education. This professional role leverages community resources to design and implement services tailored to the needs of individuals and families in their own environments.
DUTIES & RESPONSIBILITIES
Patient Care
- Formulates and executes the care plan, taking charge of the continuous interdisciplinary evaluation and creation of personalized care strategies in collaboration with the patient, their representatives, and caregivers; Initiates appropriate preventive and rehabilitative nursing actions and delivers services as prescribed by the physician in accordance with the care plan; Provides counseling for patients, caregivers, and families; Educates patients and caregivers; Maintains clinical documentation; Liaises with the physician overseeing the home health care plan and other healthcare professionals (as necessary) regarding the current care plan.
- Assesses discharge planning requirements as part of the care plan development and implements them prior to the patient's discharge.
- Maintains clinical documentation and updates the primary physician as needed, at least every sixty days.
- Communicates with the physician about the patient's needs and reports any changes in the patient's condition; obtains/receives physician's orders as required.
- Collaborates with community health professionals to coordinate the care plan.
- Engages in the HHA's quality assessment and performance improvement initiatives and participates in HHA-sponsored training sessions. Takes part in on-call responsibilities as defined by the on-call policy. Ensures that necessary equipment and services are arranged.
JOB REQUIREMENTS (Education, Experience, Knowledge, Skills & Abilities)
- Must have graduated from an accredited nursing program and hold a valid license in the state of practice.
- A minimum of two years of experience is required, with at least one year in public health or home care nursing preferred.
- Current CPR certification is mandatory.
- Must possess a valid driver's license and have access to a vehicle that is insured according to state or organizational standards and is in good working condition.
- Self-motivated and capable of working with minimal supervision.
- Exhibits excellent observational, problem-solving, verbal, and written communication skills; nursing competencies as per the checklist.
- Demonstrates the ability to independently organize and prioritize workload.
- Management experience is not required, but the role includes supervising home health aides.
- Ability to engage in prolonged or significant walking or standing. Capable of lifting, positioning, or transferring patients. Able to lift supplies and equipment. Requires considerable reaching, stooping, bending, kneeling, or crouching. Visual acuity and hearing are necessary to perform required nursing tasks.
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