RN Care Coordinator - Orthopaedic Surgery

Cleveland Clinic•Weston, FL

1d•Onsite

About The Position

Join Cleveland Clinic Weston Hospital’s team of caregivers that remain on the leading edge of technology and education, all while consistently providing patient-centered healthcare. As part of Cleveland Clinic’s Florida region, Weston Hospital is recognized as one of the top hospitals in the Miami-Fort Lauderdale and Florida regions. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world. As a Care Coordinator, you will work collaboratively with multidisciplinary care team members across the continuum of care to support high-risk patients within Orthopaedic Surgery. In this role, you will provide longitudinal care coordination and disease management for patients with chronic conditions, as well as episodic care coordination for surgical patients. You will coordinate insurance verifications, schedule appointments, facilitate referrals, and collaborate with different facilities to ensure patients receive timely and appropriate care. This position conducts patient outreach and care coordination for an assigned panel of patients to promote wellness, achieve optimal outcomes, reduce preventable emergency department visits and readmissions, and improve patient satisfaction. A caregiver in this role works days from 8:00 a.m. to 5:00 p.m.

Requirements

Graduate from an accredited school of Professional Nursing (Diploma, ADN, BSN program)
Current state licensure as a Registered Nurse (RN)
Basic Life Support (BLS) Certification through the American Heart Association (AHA) or American Red Cross
Three to five years of nursing experience

Nice To Haves

Bachelor’s of Science in Nursing (BSN)
Specialty certification
Case management background
Orthopaedic background
Experience with adult populations
Experience with EPIC

Responsibilities

Work collaboratively with a multidisciplinary care team across the continuum of care for high-risk patients to develop goals, plan interventions and maximize patient outcomes.
Provide care and disease management coordination.
Identify patients in the specialty care practice that have ongoing coordination needs and conduct targeted outreach.
Outline the nature and duration of involvement needed by the specialty care team and specialty care coordinator and identify the primary care team involved.
Utilize assessment skills and risk assessment tools to identify patients with actual or potential care needs that would require care coordination.
Utilize technological tools (registries, patient lists, care team tab, etc.) to manage populations.
Conduct comprehensive clinical assessments that include disease-specific, age-specific, medical, behavioral, pharmacy, social and end of life needs of each patient.
Inform and work with patients and their families regarding coordination of their care, provide education and coaching, monitor patient compliance with their care plan, perform reassessments regarding patient progress toward goals and update plan of care.
Serve as a liaison and advocate for patients and families.
Assist in managing transitions of care across care settings, ensuring optimal communication and planning.
Identify barriers, facilitate solutions and connect others to community resources.
Partner with other care coordinator teams such as primary and transitional care social work, rehabilitation, pharmacy, palliative care and others.
Define and ensure compliance with disease-specific care paths for specialty care or chronic disease.
Coach patient and family on self-management support.
Educate about managing a specialty or surgical condition (inclusive of preoperative, perioperative, postoperative and recovery) inclusive of prevention and health maintenance tasks.
Educate and connect to other care providers and community resources to enhance care.