Responsible for specialty care management for assigned clinics/geographical areas and other appropriate referrals within the Intermountain system. Assess, plan, educate, and advocate for patients' health needs by collaborating with the patient/family, physician(s), other health care providers, national organizations, and community resources. Collaboratively develop and implement a plan of care that meets the patient's healthcare goals, promotes shared-decision making, optimizes allocation of resources, and facilitates patient engagement and self-care management across the care continuum.Scope 1.Provides guidance to the patient through the care process and plan of care. 2. Assesses patient needs and coordinates education, discharge planning, development of a post-acute care plan, and coordination of post-acute services. 3. Directs follow-up on patients progress relative to their post-acute plan. 4. Questions and prevents duplication, fragmentation, or use of unnecessary resources; consistently questions tests/procedures for which the purpose is unclear. 5. Track and collect data on patients including demographics, length of stay, and reason for extended stay. Participate in readmission analysis on assigned patients with sending hospital and inclusive of post-acute providers. Provides reports as needed. 6. Promotes mission, vision, and values of SCL Health, and abides by service behavior standards. 7. Performs other duties as assigned. 8. May be required to float to other departments (within scope of competency and qualifications) based on business need. 9. May be required to be placed on-call during a regularly scheduled shift.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
501-1,000 employees