Care Coordination Nurse

St. Joseph Hospital & Medical Center • Phoenix, AZ

3d • Onsite

About The Position

The Care Coordination Nurse at St. Joseph’s Hospital & Medical Center leads care progression and discharge planning for an inpatient population ranging from birth to adulthood. The role coordinates healthcare and social services, balancing patient and family needs with cost-effective resources. It includes patient advocacy and attention to factors such as spiritual needs and socioeconomic barriers to support equitable, seamless transitions of care.

The nurse completes and updates discharge-planning assessments, collaborates with multidisciplinary teams and post-acute providers, and oversees discharge-plan implementation. The role supports appropriate inpatient resource utilization, identifies and addresses readmission risks, and provides patient education and advocacy while following hospital policies and promoting quality, cost-effective outcomes. Success requires critical thinking, problem-solving, communication, prioritization, and the ability to work independently and collaboratively in a fast-paced environment.

Requirements

• Two years of acute hospital clinical experience, or a master’s degree in Case Management or a Nursing field in lieu of one year of experience.
• Graduate of an accredited school of nursing.
• Registered Nurse license in Arizona or a Compact license.
• American Heart Association Basic Life Support (BLS) certification within 90 days.
• Knowledge of managed care and the payer environment.
• Critical-thinking and problem-solving skills.
• Ability to collaborate effectively with multiple stakeholders.
• Understanding of how utilization-management and case-management programs integrate.
• Ability to work as a team player and assist other team members as needed.
• Knowledge of CMS standards and requirements.

Nice To Haves

• Bachelor’s degree in Nursing (BSN) or a related healthcare field.
• At least five years of nursing experience.
• Certified Case Manager (CCM) or Accredited Case Manager (ACM-RN).

Responsibilities

• Complete and document discharge-planning assessments for patients identified through the designated screening process or upon request; reassess patients as appropriate and update plans.
• Facilitate multidisciplinary discharge planning with relevant healthcare team members, patients or their representatives, and post-acute providers, based on clinical and psychosocial needs, patient choices, and available resources.
• Oversee and evaluate implementation of discharge plans.
• Collaborate with the multidisciplinary team to support progression of care and appropriate use of inpatient resources using established evidence-based guidelines and criteria.
• Collaborate with the healthcare team and post-acute service providers to ensure timely transitions to appropriate post-acute services and settings based on patients’ clinical needs.
• Advocate for patients, provide patient education, and help identify and mitigate readmission risks.
• Balance patient and family needs with cost-effective resources while promoting quality outcomes and following hospital policies.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree