About The Position

The RN Care Coordinator works as part of a multidisciplinary team that includes physicians, social workers, discharge planning assistants, and payers. The role supports quality-driven, efficient, cost-effective, and safe patient progress through acute care and after discharge, with a focus on patient outcomes. The coordinator facilitates transitions during hospitalization, coordinates care across the continuum, supports appropriate reimbursement and resource use, and serves as a clinical resource and liaison with community agencies and facilities. The position maintains compliance with applicable QIO and CMS guidelines and carries out responsibilities in accordance with VCUHS’ Mission and Values. Every-other-weekend float position. Day and evening shifts are available. The role serves patients of all age groups. Salary range is $73,133.00–$120,744.00; actual offers depend on relevant work experience, credentials, and qualifications.

Requirements

  • Current or eligible Registered Nurse licensure in the State of Virginia at hire; current Virginia RN licensure for continued employment.
  • Complete 15 continuing education units per year for continued employment.
  • At least three years of nursing experience in an acute care setting.
  • Baccalaureate degree in nursing from an accredited school of nursing, or a bachelor’s degree in a biological, health, or social sciences field from an accredited school.

Nice To Haves

  • Academic healthcare experience.
  • One year of UM/Care Coordination experience.
  • Clinical experience with a specialty patient population.
  • Master’s degree in nursing or a healthcare-related field from an accredited program.

Responsibilities

  • Work with attending and consulting physicians to facilitate effective and efficient transitions through hospitalization.
  • Collaborate with multidisciplinary team members to meet patient needs, coordinate care across the continuum, support contracted payer reimbursement, and use resources efficiently and effectively.
  • Seek social work expertise to address psychosocial care issues and develop complex patient transition and discharge plans; interact with patients, families, healthcare professionals, and community and state agencies as needed.
  • Serve as an advanced clinical resource to the team.
  • Liaise between the hospital and community agencies or facilities to exchange clinical and referral information.
  • Maintain hospital compliance with the QIO series and CMS guidelines.
  • Use medical necessity criteria to assess the appropriateness of care level and setting; assist with denial and appeals processes; assess quality; and identify and report potential risk-management issues.
  • Participate in and complete patient safety initiatives appropriate to the position.
  • Perform job responsibilities in accordance with VCUHS’ Mission and Values.
  • Establish and maintain professional rapport with providers, patients and families, and internal customers.
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