Nurse Integrated Care Coordinator

Seven Counties Services•Louisville, KY

8d•Onsite

About The Position

ESSENTIAL JOB FUNCTIONS Provides first point of clinic contact for all new clients. Explain services available and focus on engagement of client to access services. Completes health screenings, nursing assessments and triage healthcare needs for new and ongoing clients. Participates in team meeting to develop a plan of care to address client needs. Assists clients in navigating the healthcare environment to ensure access to appropriate care. Advocates on client’s behalf with healthcare providers and managed care organizations to ensure timely quality care. Assists with coordination/access to services that address social determinants of healthcare outcomes: Provides transportation to healthcare appointments, when needed Identifies other needs, when necessary, that ensure access to healthcare Assists with access to other community resources e.g., public assistance and financial benefits. Develops knowledge base of other healthcare providers in the service area and collaborate, as needed Provides education and support wellness activities such as healthy eating, physical activity, and healthy behaviors Assists clients who have recently discharged from inpatient treatment, incarceration, residential care, and/or Emergency Department visits to ensure a transition to outpatient care using evidence-based transitional/navigation services to prevent readmissions. Collaborates with client, family/significant others to develop support networks. The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

Requirements

Licensed Practical Nurse with current active license to practice in Kentucky.
Three years of nursing experience in a hospital, physician office, or behavioral care clinic.
Experience in community setting or integrated care environment.
Reliable transportation for frequent travel.

Responsibilities

Provides first point of clinic contact for all new clients.
Explain services available and focus on engagement of client to access services.
Completes health screenings, nursing assessments and triage healthcare needs for new and ongoing clients.
Participates in team meeting to develop a plan of care to address client needs.
Assists clients in navigating the healthcare environment to ensure access to appropriate care.
Advocates on client’s behalf with healthcare providers and managed care organizations to ensure timely quality care.
Assists with coordination/access to services that address social determinants of healthcare outcomes.
Provides transportation to healthcare appointments, when needed.
Identifies other needs, when necessary, that ensure access to healthcare.
Assists with access to other community resources e.g., public assistance and financial benefits.
Develops knowledge base of other healthcare providers in the service area and collaborate, as needed.
Provides education and support wellness activities such as healthy eating, physical activity, and healthy behaviors.
Assists clients who have recently discharged from inpatient treatment, incarceration, residential care, and/or Emergency Department visits to ensure a transition to outpatient care using evidence-based transitional/navigation services to prevent readmissions.
Collaborates with client, family/significant others to develop support networks.