Care Coordinator RN Sr KHC

4 weeks ago


Marietta, Georgia, United States Wellstar Health System Full time
Job Summary

The Senior Care Coordinator RN is responsible for assessing transitional care needs, coordinating care across the continuum, and engaging with patients and families to ensure care needs are met. This role requires strong clinical expertise to partner with physicians and care teams to drive optimal and efficient treatment plans, streamline progression of care, and plan for post-discharge care.

Key Responsibilities
  • Assess transitional care needs and coordinate care across the continuum
  • Engage with patients and families to ensure care needs are met
  • Partner with physicians and care teams to drive optimal and efficient treatment plans
  • Streamline progression of care and plan for post-discharge care
  • Mentor new hires in clinical progression and case reviews
  • Collaborate with the patient and family, along with the physician(s) and other members of the care team to fully establish and support both the patient's care progression and discharge plans
  • Meet with physicians and care team routinely to collaborate on timely and efficient patient management
  • Proactively identify delays/obstacles in diagnostic or treatments within the plan of care which can lead to discharge delays
  • Actively work to resolve barriers to discharge and engage/escalate barriers to discharge to the appropriate leader for efficient resolution
  • Manage all aspects of discharge planning for assigned patients
  • Implement discharge planning timely and provide resources in an efficient manner
  • Identify and document barriers for timely disposition
  • Participate in Interdisciplinary Rounds with the patient's care team to confirm estimated date of discharge and make recommendations for best level of care transition at discharge
Requirements
  • Bachelor's degree in Nursing
  • Minimum 3 years of experience as a staff nurse in an acute care hospital setting
  • Minimum 2 years of experience as a case manager in a hospital setting or payer-based model with expertise in case management competencies
  • Knowledge regarding local, state, and federal regulations
  • Knowledge of community and state-wide resources and programs
  • Ability to work collaboratively with physicians, members of the care team, and the patient/family to assist through the continuum of care


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