Lead, Care Coordination

Orlando Health • Orlando, FL

14h

About The Position

LEAD, CARE COORDINATION
Orlando Regional Medical Center (ORMC)
ORMC Care Management
Full-Time
Position Summary
Collaborates with the assigned care coordination team to include clinical support, guidance, and educational direction while also identifying patients most likely to benefit from care coordination services to include assessing patients’ risk factors, the need for care coordination, clinical utilization management, and preventative care services.
Education/Training
Graduate of an approved school of nursing (RN), or a Master’s degree in Social Work (MSW), Mental Health (MHC) or Marriage and Family Therapy (MFT) from an accredited program.
Licensure/Certification
Florida RN license required and maintained current if graduated from an approved school of nursing.
Experience
Two (2) years of related healthcare experience and/or supervisory experience in the community with an emphasis on the population to be served in the assigned area.
Essential Functions
• Takes the lead in ensuring the continuity and consistency of care across the continuum (inpatient, emergency, and ambulatory care/outpatient) to ensure integrated delivery across all settings to include the facilitation comprehensive discharge planning (in the hospital) and follow-up care (as an outpatient).
• Develops an effective working relationship with the Licensed Mental Health Counselors/ Social Workers and the UR nurses to engage the patient/family to collaborate, advocate and problem solve, and to support and enhance their functional ability while ensuring an appropriate and timely discharge plan.
• Assists in collaboration with the assigned team to identify patients most likely to benefit from care coordination services to include assessing the patient's risk factors and needs for care coordination, clinical utilization management services, and preventative services.
• Serves as mentor to care coordination team through guidance, education, and motivation.
• Daily monitoring of team performance and progress towards discharge plans and/ or need to alter discharge plan due to change in patient condition / family needs, with a priority placed on those patients at highest risk for complication/ admission/ readmission.
• Develops collaborative relationships with the site patient care administrators, medical staff leadership,
managed care contractors, and community leaders.
• Ensures all patient care activities support established clinical standards of care and comply with various
regulatory agencies and consider age specific, developmental, and cultural needs of the patient population served.

Requirements

• Graduate of an approved school of nursing (RN), or a Master’s degree in Social Work (MSW), Mental Health (MHC) or Marriage and Family Therapy (MFT) from an accredited program.
• Florida RN license required and maintained current if graduated from an approved school of nursing.
• Two (2) years of related healthcare experience and/or supervisory experience in the community with an emphasis on the population to be served in the assigned area.

Responsibilities

• Takes the lead in ensuring the continuity and consistency of care across the continuum (inpatient, emergency, and ambulatory care/outpatient) to ensure integrated delivery across all settings to include the facilitation comprehensive discharge planning (in the hospital) and follow-up care (as an outpatient).
• Develops an effective working relationship with the Licensed Mental Health Counselors/ Social Workers and the UR nurses to engage the patient/family to collaborate, advocate and problem solve, and to support and enhance their functional ability while ensuring an appropriate and timely discharge plan.
• Assists in collaboration with the assigned team to identify patients most likely to benefit from care coordination services to include assessing the patient's risk factors and needs for care coordination, clinical utilization management services, and preventative services.
• Serves as mentor to care coordination team through guidance, education, and motivation.
• Daily monitoring of team performance and progress towards discharge plans and/ or need to alter discharge plan due to change in patient condition / family needs, with a priority placed on those patients at highest risk for complication/ admission/ readmission.
• Develops collaborative relationships with the site patient care administrators, medical staff leadership, managed care contractors, and community leaders.
• Ensures all patient care activities support established clinical standards of care and comply with various regulatory agencies and consider age specific, developmental, and cultural needs of the patient population served.

What This Job Offers

• Job Type: Full-time
• Number of Employees: 5,001-10,000 employees