RN Care Coordinator

4 weeks ago

Sparta, United States Alleghany Health Full time

POSITION SUMMARY: The RN Care Coordinator is responsible for collaboration, development, and implementation of safe and effective patient discharge planning. Works with all appropriate/interdisciplinary members of the health care team, ensuring coordination of patient care through the development and use of clinical protocols and pathways. Ensures that specific patient outcomes are achieved and that variances from established and accepted parameters are evaluated and addressed as necessary. Will ensure appropriate level of care and admission/discharge criteria are met using the measure and monitoring of severity of illness and intensity of service needs through use of INTERQUAL MONITORING CRITERIA. Will perform a wide variety of high-level patient care activities including assessment, screening for appropriateness, protocol and pathway monitoring, and overall development of a care management plan to address continuum of care need(s). Update pathway with team as indicated, coordinate services and discharge planning, and facilitate patient/family teaching, as indicated. Maintains high level knowledge of Revenue Cycle Process(es) as well as, both CMS and commercial insurance concepts, Utilization Management, CAH/other state/federal rules/regulations, as pertinent to patient populations served. Performs chart audits for RAC/MAC/denial reviews as assigned. Responsible for Core Measure abstraction, monitoring, communication(s) to involved parties to ensure optimal best practice approach. Participates in any/all Performance Improvement initiatives as assigned, including HEN initiative(s) (e.g. Reducing Readmissions), and Meaningful Use indicator monitoring. The RN care coordinator will also assist with patient care needs as needed including floor shifts. Assist within the Emergency Department with patient placement, home health/hospice referrals, DME referrals as needed. PROFESSIONAL REQUIREMENTS: Education/Experience Requirements: Graduate from an accredited school of nursing. Baccalaureate degree or current enrollment in a program preferred but not required. Three or more years of previous experience in all aspects of medical surgical nursing and a minimum of 2 years supervisory experience preferred. Knowledgeable regarding North Carolina Nurse Practice Act. Case Management experience preferred.Licensure/Certification Requirements: Current North Carolina Registered Nurse Licensure. Current BCLS certification within one month of hire. ACLS and PALS required within 6 months of hireCompliance: Alleghany Health is strongly committed to our compliance program. The employee will follow and understand all sections of AH's "Ethics and Compliance Program Manual" as it applies to their position. The employee will follow all compliance performance standards as directed by their Manager, Director, and Compliance Officer. The employee is responsible to detect compliance concerns related to their employment and report any such concerns to their Manager, Director or Compliance Officer Customer Service- the expectation of every employee within the organization is to uphold the standards outlined in the Customer Service Handbook to include Safety, Trust, Compassion, and Responsiveness.

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