Registered Nurse (RN) - Pediatric Care Coordinator - Acute Care Pediatrics, Float Position M-F
About The Position
The RN Care Coordinator is part of a multidisciplinary team that includes physicians, social workers, discharge planning assistants, and payers. The position coordinates patients’ progress through acute care and post-discharge, with a focus on quality, efficiency, cost-effectiveness, safety, and patient outcomes. The coordinator works with attending and consulting physicians and the broader care team to support effective transitions through hospitalization and across the continuum of care. The role also serves as an advanced clinical resource and liaison between the hospital and community agencies or facilities. The coordinator helps ensure care is appropriately reimbursed by payers and resources are used effectively. Responsibilities include supporting complex transition and discharge planning, applying medical necessity criteria, assisting with denials and appeals, assessing quality, identifying and reporting potential risk-management issues, and maintaining compliance with QIO series and CMS guidelines. The position also participates in applicable patient-safety initiatives and performs responsibilities in accordance with VCUHS’ Mission and Values.
Requirements
- Licensed Registered Nurse in Virginia, or eligible for Virginia licensure, at hire; current Virginia RN licensure required for continued employment.
- Complete 15 Continuing Education Units per year.
- Minimum of three years of nursing experience in an acute care setting.
- Baccalaureate Degree in Nursing from an accredited School of Nursing.
- Physical ability to lift 20–50 lbs.
- Ability to handle prolonged sitting and walking distances.
- Strong recall, reasoning, problem-solving, hearing, clear speech, legible writing, reading, and logical thinking.
- Ability to maintain a steady pace, handle multiple priorities, manage frequent and intense customer interactions, and adapt to frequent change.
Nice To Haves
- Academic healthcare experience.
- One year of utilization management (UM) or 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 the multidisciplinary team to coordinate care across the continuum, meet patient needs, support appropriate payer reimbursement, and ensure efficient resource use.
- Seek social worker expertise to address psychosocial care issues and develop complex patient transition or discharge plans as needed.
- Interact with patients, family members, healthcare professionals, and community and state agencies to coordinate care.
- 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 Quality Improvement Organization (QIO) series and CMS guidelines.
- Use medical necessity criteria to assess the appropriateness of care level and setting.
- Assist with the denial and appeals process.
- Assess quality and identify and report potential risk-management issues.
- Participate in and complete patient-safety initiatives appropriate to the position.
- Establish and maintain professional rapport with providers, patients and families, and internal customers.
- Conduct job responsibilities according to VCUHS’ Mission and Values.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
