Job Summary
The RN Care Coordinator is responsible for overseeing the progression of care and discharge planning for identified patients requiring these services. The position’s emphasis will be on care coordination communication and collaboration with utilization management nursing physicians ancillary departments insurers and post acute service providers to progress the care toward optimal outcomes at the appropriate level of care. The RN Care Coordinator advocates for the patient and family by identifying, valuing and addressing patient choice, spiritual needs, cultural language and socioeconomic barriers to care transitions. In addition the RN Care Coordinator strives to enhance the patient experience.
Responsibilities
Complete and document a discharge planning assessment on patients identified by the designated screening process or upon request, reassessing as appropriate and updating the plan accordingly.
Facilitate the development of a multidisciplinary discharge plan engaging other relevant health team members, the patient and/or patient representative and post‑acute care providers in accordance with the patient’s clinical or psychosocial needs, choices and available resources.
Oversee and evaluate the implementation of the discharge plan.
Collaborate with the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence‑based guidelines/criteria.
Collaborate with the healthcare team and post‑acute service providers to ensure timely and smooth transitions to the most appropriate type and setting of post‑acute services based upon patients’ clinical needs.
Identify risk for readmission and implement interventions to mitigate those risks for at least a 30‑day period.
Deliver appropriate patient notifications and related documentation.
Provide patient education and advocacy.
Participate in performance improvement teams and programs as necessary.
Job Requirements
Minimum
Minimum two (2) years of acute hospital clinical experience – or a Masters degree in Case Management or Nursing field in lieu of 1 year experience.
Current CA RN licensure.
AHA BLS required within 3 months of hiring if located within hospital.
Preferred
At least five (5) years of nursing experience.
Certified Case Manager (CCM) or Accredited Case Manager (ACM‑RN) or UM Certification.
Bachelor’s Degree in Nursing (BSN) or related healthcare field.
Knowledge, Skills and Abilities
Able to apply clinical guidelines to ensure progression of care.
Understanding how utilization management and case management programs integrate.
Knowledge of CMS standards and requirements.
Knowledge of managed care and payer environment preferred.
Collaborate/Communicate effectively with multiple stakeholders.
Critical thinking and problem‑solving skills.
Thrive in a fast‑paced self‑directed environment.
Highly organized with excellent time‑management skills.
Proficient in prioritizing work and delegating where indicated.
Ability to work as a team player and assist other members of the team when needed.
Where You'll Work
Dignity Health Mercy San Juan Medical Center is a 384‑bed, not‑for‑profit Level 2 Trauma Center located in Carmichael, California. It serves north Sacramento County and south Placer County and is one of the area's largest and most comprehensive medical centers. The facility offers comprehensive stroke and spine center excellence, and has received certificates of excellence for perinatal care and joint replacements.
Pay Range
$69.35 - $84.19 per hour
Job Details
Seniority level: Not Applicable
Employment type: Full‑time
Job function: Health Care Provider
Industries: Wellness and Fitness Services, Hospitals and Health Care, Medical Practices