Registered Nurse (RN) - Coordinator RN Care Inpt

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Job Type:

Regular

Scheduled Hours:

0

Job Summary:

The Care Coordinator, in collaboration with the patient/family, social workers, physicians and interdisciplinary team, ensures patient progression through the continuum of care in an efficient and cost-effective manner. Primary responsibilities include:
• Identifying, initiating and managing optimum patient flow/throughput to enhance continuity of care.
• Planning and facilitating coordinated, safe transitions to the next level of care required
• Promoting patient satisfaction, and quality outcomes.
• Targeting an optimal length of stay based on the patient’s individual response to treatment, procedures, and interventions. Maximizes contracted benefits and available services in care management planning.
• Providing care management planning to ensure quality patient care, ensures regulatory compliance, and meets patient/family needs.

Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.

Job Description:

On a concurrent basis the Care Coordinator (CC) utilizes appropriate/standardized criteria to determine the optimal level of care required for the patient and alternate care delivery options. 

• On concurrent basis, assesses the appropriateness of the level of care/care management; diagnostic testing and clinical procedures; quality and clinical risk issues; and documentation of medical record completeness. 
• Records variances through the established care coordination and quality improvement processes.  
• Documents all reviews in designated software system.
• Conducts admission and concurrent medical record review using established medically necessity criteria as described by policy in accordance with regulatory and contractual requirements as well as internal policy.
• Screens for appropriateness of admission (IP vs. Observation) and continued stay for medical necessity.
• Escalates as appropriate per policy.
• Reviews clinical and demographic information for accuracy and completeness to ensure that hospital care delivered meets payer requirements for observation or inpatient services. 
• Acts as a resource and provides staff and physician education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.
• Assists in monitoring critical care bed utilization.
• Ensures patient progression through the continuum in an efficient, cost-effective manner in collaboration and communication with patient/family, physicians and the interdisciplinary team.
• Acts as patient advocate by negotiating for and coordinating resources with agencies and vendors during inpatient and transitions to post-acute care.
• Performs initial Care Management assessment to determine care coordination and discharge planning.
• Coordinates and implements the discharge plan for patients with post- acute care needs in collaboration with the Social Worker.
• Identifies patients/family for Social Worker referral who would benefit from support needed to better enable patients/family in dealing with impact of illness on family functioning and achieving maximum benefits from healthcare services.
• Participates in ongoing communication with physician to develop a collaborative relationship aimed at improving clinical treatment goals and appropriate and timely discharge for the patient.
• Comprehensively assesses patient’s biophysical, psychosocial, and environmental needs focused toward discharge planning initiatives – makes appropriate referrals.
• Provide expertise and support to the treatment team regarding the management of chronic disease/complex patients.
• Identifies and participates in the development of strategies to reduce unnecessary LOS, resource consumption, implementing and documenting results.
• Provide expertise to the team in developing treatment and discharge planning strategies for frequently admitted patients.
• Ensures that the proper sequencing and scheduling of interventions, treatments and procedures are in accordance with the patient’s treatment plan, that care is expedited, and care delays and denial of payment are avoided.
• Identifies (internal and external) variances/obstacles to efficient or timely care and positive patient outcomes and intervenes with the healthcare team to overcome or elim