Care Coordinator RN

CommonSpirit Health • Pueblo, CO

10d • Onsite

About The Position

The RN Care Coordinator oversees the progression of care and discharge planning for identified patients, promoting quality and cost-effective outcomes while adhering to hospital policies and regulations. The role coordinates and collaborates with utilization management, nursing, physicians, ancillary departments, insurers, and post-acute providers to progress care toward optimal outcomes at the appropriate level. The Care Coordinator advocates for patients and families by identifying and addressing barriers to care transitions and working to enhance the patient experience.

The position facilitates multidisciplinary discharge planning based on patients’ clinical or psychosocial needs, choices, and available resources. It completes and documents discharge planning assessments for patients identified through the designated screening process or by request, and reassesses patients as appropriate. The role also identifies readmission risks and implements interventions to mitigate them for at least 30 days, oversees discharge plan implementation, and collaborates with the multidisciplinary team to support care progression and appropriate inpatient resource utilization using established evidence-based guidelines and criteria.

Requirements

• Graduate of an accredited school of nursing.
• At least 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.
• RN license in the state or states covered by the role, as applicable.
• BLS certification required within three months of hiring.

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), Accredited Case Manager (ACMRN), or UM Certification.

Responsibilities

• Facilitate development of a multidisciplinary discharge plan involving relevant health team members, the patient or patient representative, and post-acute care providers.
• Coordinate with the healthcare team and post-acute service providers to support timely transitions to appropriate post-acute services based on patients’ clinical needs.
• Complete and document discharge planning assessments for patients identified by the designated screening process or upon request, and reassess patients as appropriate.
• Identify readmission risks and implement interventions to mitigate those risks for at least 30 days.
• Oversee and evaluate implementation of the discharge plan.
• Collaborate with the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence-based guidelines and criteria.
• Coordinate and communicate with utilization management, nursing, physicians, ancillary departments, insurers, and post-acute providers.
• Advocate for patients and families by identifying and addressing barriers to care transitions.

What This Job Offers

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