Care Coordinator(RN) - Case Management (Per Diem, Days)
About The Position
The Care Coordinator has responsibility for coordinating the care and services for assigned patients for an episode of illness or treatment in collaboration with the patient, family, physician, patient care team, and payors. The Care Coordinator utilizes advanced clinical skills to facilitate the provision of care which includes the assessment, planning, intervention and evaluation principles of the nursing process. The Care Coordinator promotes and evaluates the effective utilization of resources using current clinical knowledge, awareness of community services, and assuming a leadership role with the patient care team to achieve optimal clinical and resource outcomes. The Care Coordinator evaluates and analyzes quality/utilization cases, admission/discharge criteria, observation/1-day stays, readmits in 30 days, Medicare and diagnosis related criteria. Participates in outlier review on an ongoing basis. In addition, the Care Coordinator may be assigned to the Emergency Department. In collaboration with the patient/family, multidisciplinary team including physicians and payors ensure the patient’s progress along with emergency episode of care in an efficient and cost effective manner for assigned case load. Advocates for the patient and family throughout the entire episode of care. Maintains availability to the patient/family as a resource to facilitate communication among providers and to monitor services rendered. Remains involved until the patient is discharged or appropriately transferred to the acute care setting or an alternate level of care. Initiate appropriate clinical pathways based on admission diagnosis and to serve as a resource person for utilization management purposes.
Requirements
- Two years of acute care clinical experience, one year of recent Case Management experience in an Acute or Post Acute setting, or a Master's in Nursing with a Case Management emphasis.
- Current licensure with the California Board of Registered Nursing
- Current CPR recognition
- Assessment, planning, intervention, and evaluation of patient care.
- Demonstrates current clinical nursing knowledge as evidenced by completion of staff nurse OCAT and passing medication administration examination.
- Maintains and regularly updates clinical nursing knowledge by completion of the Skills Fair on an annual basis.
- Understanding of third party reimbursement methodologies.
- Critical thinking and analytical skills.
- Must have excellent communication and interpersonal skills to establish a high degree of rapport and professional interaction.
- Must be able to maintain strict confidentiality at all times.
- Ability to build positive working relationships with physicians and external agencies.
- Ability to communicate with multiple levels of the organization (e.g., managers, physicians, clinical, and support staff).
- Capable of using (Microsoft Office Suite) Microsoft Word, Excel, Outlook, Midas, Chart Max, and Epic computer systems.
- Organizational and multi-tasking skills are essential.
- Must be able to fulfill the essential functions of the position.
Nice To Haves
- Bachelor’s degree in nursing
- Experience in acute clinical case management and utilization review
- Working knowledge of managed care requirements and hospital information systems
- Prefer experience in area of assignment.
- Must be able to maintain confidentiality of patient information, be a patient advocate, be collaborative and able to delegate when appropriate.
- Must have initiative to assume fiscal responsibilities.
Responsibilities
- Coordinating the care and services for assigned patients
- Facilitating the provision of care
- Promoting and evaluating the effective utilization of resources
- Evaluating and analyzing quality/utilization cases, admission/discharge criteria, observation/1-day stays, readmits in 30 days, Medicare and diagnosis related criteria
- Participating in outlier review on an ongoing basis
- Ensuring the patient’s progress along with emergency episode of care in an efficient and cost effective manner for assigned case load
- Advocating for the patient and family throughout the entire episode of care
- Maintaining availability to the patient/family as a resource to facilitate communication among providers and to monitor services rendered
- Remaining involved until the patient is discharged or appropriately transferred to the acute care setting or an alternate level of care
- Initiating appropriate clinical pathways based on admission diagnosis and to serve as a resource person for utilization management purposes.
Benefits
- $0 premium medical plan to include vision insurance
- Prescription and dental group insurance
- Retirement with employer match
- Generous paid time off (PTO) plan that starts accruing immediately and can be used as it's earned
- Extended Sick Leave
- Flexible Spending Accounts for unreimbursed medical expenses and dependent care
- Employee Assistance Program
- Educational Assistance
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What This Job Offers
Job Type
Part-time
Career Level
Mid Level
