Care Coordinator (RN) - Neurology

VCU Health•Richmond, VA

About The Position

The RN Care Coordinator is part of a multidisciplinary team that includes physicians, social workers, discharge planning assistants, and payers. The role supports patients through acute care and post-discharge, ensuring care is quality-driven, efficient, cost-effective, safe, patient-focused, and outcome-oriented. The Care Coordinator works with attending and consulting physicians and the multidisciplinary team to coordinate care across the continuum, facilitate effective transitions during hospitalization, and ensure appropriate payer reimbursement and efficient use of resources. The role also serves as an advanced clinical resource and a liaison between the hospital and community agencies or facilities. It maintains compliance with Quality Improvement Organization (QIO) series and CMS guidelines, uses medical necessity criteria to assess appropriate levels and settings of care, assists with denials and appeals, assesses quality, identifies and reports potential risk-management issues, and participates in applicable patient-safety initiatives. The position requires a Virginia RN license or eligibility for licensure at hire and current Virginia RN licensure during employment, along with 15 continuing education units per year. Day and evening shifts are available. The role serves all age groups and is conducted in accordance with VCUHS’ Mission and Values.

Requirements

Current or eligible Registered Nurse licensure in Virginia at hire; current Virginia RN licensure for continued employment.
At least three years of nursing experience in an acute care setting.
Baccalaureate degree in Nursing from an accredited school of nursing, or a bachelor’s degree in a biological, health, or social sciences field from an accredited school.
Complete 15 continuing education units per year.
Physical ability to lift 20–50 lbs.
Ability to manage prolonged sitting and walking distances.
Strong recall, reasoning, problem-solving, hearing, clear speaking, legible writing, reading, and logical thinking.
Ability to maintain a steady pace, handle multiple priorities and frequent intense customer interactions, and adapt to frequent change.

Nice To Haves

Academic healthcare experience.
One year of UM/Care Coordination experience.
Clinical experience with a specialty patient population.
Master’s degree in Nursing or a healthcare-related field from an accredited program.

Responsibilities

Work with attending and consulting physicians to facilitate effective and efficient transitions through hospitalization.
Collaborate with the multidisciplinary team to meet patient needs, coordinate care across the continuum, support appropriate payer reimbursement, and use resources efficiently and effectively.
Seek social workers’ expertise to address psychosocial patient-care issues and develop complex patient transition or discharge plans as needed.
Interact with patients, family members, healthcare professionals, and community and state agencies to support care coordination.
Serve as an advanced clinical resource to the team.
Liaise between the hospital and community agencies or facilities to exchange clinical and referral information.
Maintain hospital compliance with the Quality Improvement Organization (QIO) series and CMS guidelines.
Use medical necessity criteria to assess the appropriateness of the level and setting of care.
Assist with the denial and appeals process.
Assess quality and identify and report potential risk-management issues.
Participate in and complete patient-safety initiatives appropriate to the position.
Establish and maintain professional rapport with providers, patients and families, and internal customers.
Complete 15 continuing education units per year to maintain continued-employment requirements.