Registered Nurse - Care Coordinator - Care Management

Parkland Health

1d•Onsite

About The Position

The Registered Nurse - Care Coordinator establishes and maintains an efficient, cost-effective care management process. The role assesses patients’ financial and medical eligibility and medical necessity, and develops, implements, and monitors individual plans of care. The coordinator communicates care plans with patients, families, and Parkland staff to support quality care throughout the healthcare continuum and compliance with program and Parkland policies and procedures. The position also maintains knowledge and skills in utilization review, care coordination, performance improvement, and professional licensure and certification. This is a full-time, onsite evening position working 12:30 p.m. to 11:00 p.m., four days a week.

Requirements

Graduate of an accredited school of Nursing.
At least two years of hospital or community-based patient-care nursing experience; experience in the assigned clinical area is preferred.
Current, valid RN license or temporary RN license from the Texas Board of Nursing, or a valid Compact RN license.
Current healthcare provider BLS for Healthcare Providers certification from the American Heart Association, American Red Cross, or Military Training Network.
Provide care in accordance with the Texas Nursing Practice Act, established protocols, the multidisciplinary plan of care, and clinical-area standards.
Communicate and collaborate effectively with diverse patients, families, and healthcare staff.
Demonstrate working knowledge of specific patient populations and the disease processes affecting them.
Demonstrate working knowledge of PC operations and word-processing software in a Windows environment.
Demonstrate working knowledge of laws and regulations governing Medicare, Medicaid, and community-based funding sources.
Be self-directed and capable of setting priorities and solving problems.
Demonstrate patient-centered, patient-valued behaviors.

Nice To Haves

Hospital or community-based patient-care nursing experience in the assigned clinical area.

Responsibilities

Assess patients on the assigned Care Coordination team and develop case management plans using information gathered from patients, physicians, and other healthcare team members.
Determine patient funding sources and potential eligibility, and develop objectives, goals, and actions to address identified needs.
Use hospital-approved review criteria to assess bed status, identify at-risk populations using approved screening tools, follow reporting procedures, and ensure admission status is documented.
Collaborate with patients and multidisciplinary team members to implement care plans, monitor progress, and intervene as needed to support patient-focused, high-quality, efficient, and cost-effective care.
Communicate financial counseling information as appropriate, address system barriers to diagnostic or treatment progress, and proactively resolve discharge delays and obstacles.
Build and maintain care-plan consensus among patients and families, physicians, and payers; advocate for coverage of needed community services; and coordinate resources for transitions to the appropriate next level of care.
Communicate and update care plans with patients and families, reassess plans for effectiveness, complete care coordination documentation, and work with nursing and other disciplines to meet discharge and teaching needs.
Collaborate with the healthcare team to identify best practices for patient outcomes and develop reporting mechanisms to communicate outcomes.
Perform utilization management activities for assigned patients, apply approved criteria to assess admissions and continued stays, and document findings according to department standards.
Monitor length of stay and ancillary resource use and take action to improve both.
Monitor outcome variances, identify their causes, and implement improvement actions.
Identify efficient and cost-effective ways to provide appropriate care and support cost-containment efforts by recommending performance improvement opportunities.
Coordinate with the Care Management team on covered-day reimbursement certification or authorization, discuss payer criteria and issues with clinical staff, and follow up to resolve payer problems.
Coordinate patient transitions through the healthcare system, including services, health promotion and counseling, disease prevention, health education and screening, and community resource connections.
Participate in special projects and serve on committees as assigned.