RN Care Coordinator

CommonSpirit Health•Sacramento, CA

19d•Remote

About The Position

As a RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient experience. Every day, you will strategically assess, plan, and facilitate comprehensive care across the continuum, expertly advocating for patients while collaborating with physicians, nursing, departments, insurers, and post-acute providers to ensure timely, high-quality transitions. To be successful in this role, you will possess strong clinical acumen, exceptional communication and advocacy skills, and a strategic mindset, all driven by a passion for optimizing patient care across every touchpoint. Concurrently reviews patient's records to collect data to carefully understand the needs of the patient by scrutinizing their background history, understanding their current needs, and arranging for their wellbeing. Coordinates with other disciplines to facilitate the patient's individual needs. Makes plans to resolve unexpected care requirements. Anticipates and identifies variances in the care process related to those identified needs. Assists in development, implementation and revision of individual care plans; assures that services provided are specified in the Care Plan and monitors progress toward goals, including documentation of daily improvement in patient's condition or otherwise notes lack of improvement for reassessment of appropriateness of care plan. When barriers are identified, assists the patient and the family/caregiver in developing, documenting and implementing appropriate care plans to access agencies, resources and care providers. Teach, coach and educate the patient, family and/or caregiver about their disease process to recognize signs and symptoms of worsening disease and how to take appropriate measures. Documents patient, family or caregiver's knowledge regarding medical condition(s), and indicates when condition is worsening and develop a plan for how to respond. This position is work from home within driving distance of the Greater Sacramento, CA region, with occasional onsite meetings. Please note: This position will work rotating Saturdays.

Requirements

2 years clinical experience as a Registered Nurse (RN) in acute, ambulatory care, home health, skilled nursing facility, medical group or health plan setting. Masters Of Nursing (MSN) concentration in Case Management can serve as a substitute for the experience requirement.
Clear and current CA RN license
Excellent customer service and presentation skills are a must
Strong interpersonal and written communication skills are essential
Demonstrated ability to apply analytical and problem solving skills
Ability to demonstrate leadership skills to delegate and provide direction/guidance to multidisciplinary team.
Demonstrated ability to manage multiple tasks or projects effectively Ability to work independently as needed with a high degree of detail orientation. Ability to work efficiently in a fast-paced environment with changing priorities.
Knowledge of regulatory and accreditation standards (URAC, NCQA) and complex case management (CMSA).
Knowledge of community resources.
Knowledge of capitation/HMO, insurance payers and government healthcare plans and audits.

Nice To Haves

Bachelors of Nursing (BSN) preferred
Accredited Case Manager (ACM), Certified Case Manager (CCM), or Case Management Nurse (RN-BC CASE) preferred

Responsibilities

Strategically assess, plan, and facilitate comprehensive care across the continuum
Expertly advocating for patients while collaborating with physicians, nursing, departments, insurers, and post-acute providers to ensure timely, high-quality transitions
Concurrently reviews patient's records to collect data to carefully understand the needs of the patient by scrutinizing their background history, understanding their current needs, and arranging for their wellbeing
Coordinates with other disciplines to facilitate the patient's individual needs
Makes plans to resolve unexpected care requirements
Anticipates and identifies variances in the care process related to those identified needs
Assists in development, implementation and revision of individual care plans; assures that services provided are specified in the Care Plan and monitors progress toward goals, including documentation of daily improvement in patient's condition or otherwise notes lack of improvement for reassessment of appropriateness of care plan
When barriers are identified, assists the patient and the family/caregiver in developing, documenting and implementing appropriate care plans to access agencies, resources and care providers
Teach, coach and educate the patient, family and/or caregiver about their disease process to recognize signs and symptoms of worsening disease and how to take appropriate measures
Documents patient, family or caregiver's knowledge regarding medical condition(s), and indicates when condition is worsening and develop a plan for how to respond