Caring Transitions Jobs in Usa
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Local Contract Nurse RN - PCU - Progressive Care Unit
✦ New
Salary not disclosed
Job Description
WCS Healthcare Partners is seeking a local contract nurse RN PCU - Progressive Care Unit for a local contract nursing job in Auburn, New York.
Job Description & Requirements
- Specialty: PCU - Progressive Care Unit
- Discipline: RN
- Duration: 13 weeks
- 36 hours per week
- Shift: 12 hours, nights
- Employment Type: Local Contract
WCS Healthcare is currently seeking an experienced Step‑Down RN for a contract assignment at a prestigious hospital in Auburn, NY.
Job Function:
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- Night Shift.
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- 3x12: 7pm-7:30am.
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- Deliver high‑quality patient care using the principles of Relationship‑Centered Care, integrating theory, research, and evidence‑based practice.
/n
- Assess and evaluate patient needs while applying strong critical‑thinking skills to guide clinical decision‑making.
/n
- Integrate comprehensive assessment and intervention skills into all aspects of nursing care.
/n
- Prioritize patient care activities, including teaching, rounding, coaching, discharge planning, and appropriate delegation.
/n
- Educate patients and caregivers about the plan of care, transitions of care, health promotion, and disease prevention—anticipating needs and readiness to learn.
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Job Requirements:
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- 1+ years RECENT Step‑Down experience.
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- 1 year POST‑CATH experience (required).
/n
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- Telemetry experience.
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- Charting: Allscripts (required).
/n
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- BLS, ACLS, NIHSS.
/n
/n
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Disclosure: The hourly rates and/or salaries listed may or may not reflect total compensation packages including bonus and fringe benefits, etc., nor are the advertisement(s) posted a guarantee of a certain compensation package for a position or bona fide offer of employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
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ITAC1
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#LI-DNP
43117
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White Cap Search Partners Job ID #43117. Posted job title: RN - PCU - Local Contract
About WCS Healthcare Partners
With WCS Healthcare Partners, every Job Seeker grows stronger, moving one step forward with each job placement. We take the time to get to know the needs and qualifications of each Healthcare professional to match you with the right clinical setting, patient population, merging your compensation and career goals with your desired work environment. Our recruiters are experts at navigating the dynamic nature of healthcare employers to get your resume in front of the right decision makers.
NURSING
● Registered Nurses (RN)
● Licensed Practical Nurses (LPN)
● Travel Nursing
● Quality Assurance/Review, Performance Improvement, HEDIS
● Nursing Leadership
● Case Management
ALLIED HEALTH
● Technologists: Medical, Laboratory, Cardiac, RadTech, X-Ray
● Therapy: Physical, Occupational and Speech Therapy
● Social Work: LCSW/LMSW, Case Management, Care Coordination
● Med Support: Medical Assistants, Phlebotomy, Surgical/Sterile Techs
● Pharmacists and Pharmacy Techs
● Dental Hygienist, Dental Assistants
OPERATIONS & FINANCE
● Practice Management
● Clinical Operations
● Administrative Support
● Reception, Clerical, Call Center
● Claims Appeals/Denials/Reimbursement
● Insurance Pre-Authorizations
● Medical Billing/Coding
Benefits
- 401k retirement plan
- Weekly pay
WCS Healthcare Partners is seeking a local contract nurse RN PCU - Progressive Care Unit for a local contract nursing job in Auburn, New York.
Job Description & Requirements
- Specialty: PCU - Progressive Care Unit
- Discipline: RN
- Duration: 13 weeks
- 36 hours per week
- Shift: 12 hours, nights
- Employment Type: Local Contract
WCS Healthcare is currently seeking an experienced Step‑Down RN for a contract assignment at a prestigious hospital in Auburn, NY.
Job Function:
/n
- Night Shift.
/n
- 3x12: 7pm-7:30am.
/n
- Deliver high‑quality patient care using the principles of Relationship‑Centered Care, integrating theory, research, and evidence‑based practice.
/n
- Assess and evaluate patient needs while applying strong critical‑thinking skills to guide clinical decision‑making.
/n
- Integrate comprehensive assessment and intervention skills into all aspects of nursing care.
/n
- Prioritize patient care activities, including teaching, rounding, coaching, discharge planning, and appropriate delegation.
/n
- Educate patients and caregivers about the plan of care, transitions of care, health promotion, and disease prevention—anticipating needs and readiness to learn.
/n
/n
Job Requirements:
/n
- 1+ years RECENT Step‑Down experience.
/n
/n
- 1 year POST‑CATH experience (required).
/n
/n
- Telemetry experience.
/n
/n
- Charting: Allscripts (required).
/n
/n
- BLS, ACLS, NIHSS.
/n
/n
/n
Disclosure: The hourly rates and/or salaries listed may or may not reflect total compensation packages including bonus and fringe benefits, etc., nor are the advertisement(s) posted a guarantee of a certain compensation package for a position or bona fide offer of employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
/n
/n
ITAC1
/n
#LI-DNP
43117
/n
White Cap Search Partners Job ID #43117. Posted job title: RN - PCU - Local Contract
About WCS Healthcare Partners
With WCS Healthcare Partners, every Job Seeker grows stronger, moving one step forward with each job placement. We take the time to get to know the needs and qualifications of each Healthcare professional to match you with the right clinical setting, patient population, merging your compensation and career goals with your desired work environment. Our recruiters are experts at navigating the dynamic nature of healthcare employers to get your resume in front of the right decision makers.
NURSING
● Registered Nurses (RN)
● Licensed Practical Nurses (LPN)
● Travel Nursing
● Quality Assurance/Review, Performance Improvement, HEDIS
● Nursing Leadership
● Case Management
ALLIED HEALTH
● Technologists: Medical, Laboratory, Cardiac, RadTech, X-Ray
● Therapy: Physical, Occupational and Speech Therapy
● Social Work: LCSW/LMSW, Case Management, Care Coordination
● Med Support: Medical Assistants, Phlebotomy, Surgical/Sterile Techs
● Pharmacists and Pharmacy Techs
● Dental Hygienist, Dental Assistants
OPERATIONS & FINANCE
● Practice Management
● Clinical Operations
● Administrative Support
● Reception, Clerical, Call Center
● Claims Appeals/Denials/Reimbursement
● Insurance Pre-Authorizations
● Medical Billing/Coding
Benefits
- 401k retirement plan
- Weekly pay
contract
RN In Hospital Transiton of Care Case Manager - Relocation Offered!
✦ New
USD $89,065.00/Yr. - USD $162,801.00/Yr
About this Job:
General Summary of Position
An exciting new role has been added to the team, offering a unique opportunity to make a direct impact on patient outcomes at a critical point in care. The In-Hospital Transition of Care RN Case Manager partners closely with hospital discharge planners to coordinate patient care at discharge, ensuring seamless continuity across care settings and reducing avoidable readmissions through proactive coordination, patient education, and timely follow-up.
This position is based at either Washington Hospital Center or The Psychiatric Institute of Washington (PIW) and offers the opportunity to work across diverse patient populations, with flexibility to provide coverage at both locations.
In this highly collaborative and autonomous role, the RN Case Manager manages a complex caseload and takes ownership of case management program(s), driving high-quality, cost-effective outcomes while enhancing the patient experience. The role includes coordinating and managing care for members/enrollees, completing pre-authorization reviews to ensure medical necessity and timely access to services, and conducting pharmacy reviews aligned with the population served. Working alongside an interdisciplinary team, you will play a key role in discharge planning, connecting patients to the right resources, and ensuring smooth transitions across the continuum of care.
This is an excellent opportunity for a nurse who thrives in a fast-paced environment, values critical thinking and autonomy, and is passionate about improving care transitions and patient outcomes. We are committed to fostering a supportive, inclusive environment where associates from diverse backgrounds can grow, advance, and make a meaningful difference.
Primary Duties and Responsibilities
- Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
- Actively develops and manages complex case management cases and develops individualized plans of care according to NCQA standards/ guidelines and the District of Columbia Contract.
- Acts as a liaison to MedStar Family Choice contracted vendors to facilitate care. Identifies gaps in contracted services and develops a plan to access care.
- Acts as an advocate while assisting members/enrollees to coordinate and gain access to medical psychiatric psychosocial and other essential services to meet their healthcare needs. Authorizes and monitors covered services according to policy.
- Assists hospital case management staff with discharge planning if applicable. Makes recommendation to alternate tier of Case Management programs or level of care as acuity necessitate.
- Attends and participates in MFC staff meetings Clinical Operations department meetings Special Needs Forums work groups District/ community agencies meetings etc. as assigned. Provides input completes assignments and shares new findings with other staff. Contributes to the achievement of established department goals and objectives and adheres to department policies procedures quality standards and safety standards. Complies with governmental and accreditation regulations.
- Provides face to face case management in the community as the member/enrollee's health necessitate.
- Demonstrates behavior consistent with MedStar Health mission vision goals objectives and patient care philosophy.
- Demonstrates skill and flexibility in providing coverage for other staff.
- For assigned Case Management program(s) develops strategies assessment(s) and evaluation/goal tools according to NCQA standards/ guidelines and District of Columbia Contract for the population served. Utilizes standards/ guidelines to manage and document interactions for the program (s). Responsible for verifying that assigned program utilizes up-to-date standards in the medical and behavioral health community for the population served. Keeps informed about disease processes treatment modalities and resources.
- Identifies and reports potential coordination of benefits subrogation third party liability worker's compensation cases etc. Identifies quality risk or utilization issues to appropriate MedStar personnel.
- Identifies inpatients requiring additional services and initiates care with appropriate practitioners.
- Maintains current knowledge of MFC benefits and enrollment issues in order to accurately coordinate services.
- Maintains timely and accurate documentation in the clinical software system per Clinical Operation department's policy.
- Monitors utilization of all services for fraud waste and abuse.
- Performs telephonic ACD line coverage for Clinical Operations' needs.
- Enters authorization as appropriate to the program and sends the reviews to Medical Director as appropriate. Coordinates review decisions and notifications per policy NCQA standards/ guidelines and District of Columbia Contract for timely decision making.
- Participates in meetings and on committees and represents the department and hospital in community outreach efforts.
- Participates in multi-disciplinary quality and service improvement teams.
Minimal Qualifications
Education
- Graduate of an accredited School of Nursing required and
- Bachelor's degree preferred
Experience
- 1-2 years Case management experience required and
- 1-2 years UM or related experience required and
- 3-4 years Diverse clinical experience required
Licenses and Certifications
- RN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the District of Columbia and/or the State of Maryland based on work location(s) Upon Hire required and
- CCM - Certified Case Manager Upon Hire preferred
Knowledge Skills and Abilities
- Verbal and written communication skills. Ability to use computer to enter and retrieve data. Ability to create edit and analyze Microsoft office (Word Excel and PowerPoint) preferred.
permanent
RN Patient Care Navigator
Salary not disclosed
Hourly Pay Range:
$40.45 - $62.70 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
* Position: RN Patient Care Navigator
* Location: Skokie, IL
* Full Time: 40 hours
* Hours: Monday-Friday, 8:00a-4:30p rotating every 3rd weekend
* I winter holiday (Thanksgiving, Christmas, New Year) and 1 summer (Labor Day, July 4th, Memorial Day) coverage
* Required Travel: Highland Park, Glenbrook, Evanston, Swedish based on clinical needs, less than 1%
A Brief Overview:
The RN Transitional Care Navigator (Population Health) is responsible for the case management, care coordination management, and utilization management of his/her population of patients across multiple care levels and settings. Serves as a catalyst to promote patients understanding their diagnosis, treatment options, and available resources and ensure that they are connected with the optimal resources across the continuum of care. This role will coordinate and facilitate smooth and safe care transitions while ensuring quality cost-effective patient outcomes. Serves as a liaison between their patient population and all other providers. Will be responsible for key metrics of success, which include improving the overall cost of care, length of stay optimization, reduction in excess days, reduction in SNF utilization and improvement in SNF care transitions, reduction in 30-day readmission rate and ED utilization.
What you will do:
* Guides high-risk patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patients with navigating the continuum of care. Eliminates barriers to patient's access to health care services and facilitates continuity of care/care coordination.
* Establishes and documents an individualized plan of care for assigned patients using evidence-based treatment guidelines considering the patients individual health goals with a focus on wellness, health management, disease prevention and chronic disease management.
* Partners with the healthcare team to ensure clinical decision-making, implementation of recommendations, and discharge planning are timely and appropriate.
* Performs daily coordination between multiple departments, multi-disciplinary team, medical clinics, and community outreach to gain knowledge of patient, assure patient safety, smooth transitions of care, and manage utilization and total cost of care.
* Acts as advisor/educator by partnering with social work in providing emotional support including goals of care and counseling. Provides and/or arranges clinical education including medication management, community resources, financial resources, and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making.
* Facilitates appointments for appropriate consultations and support services within established protocols
* Completes Utilization Management for assigned patients.
* Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness of admissions and continued stays and documents findings based on Department standards.
* Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
* May need to travel to visit the patient at home from time to time.
* Available to his/her assigned patient population and participates as part of a call coverage structure.
* Participates in the collection and analysis of data to identify under/over utilization; improve resource consumption; promote potential reduction in cost; and enhance quality of care consistent with organization strategic goals and objectives.
*
What you will need:
* Bachelors Degree Health Administration Required Or
* Bachelors Degree Nursing Required
* 3 Years Utilization review, discharge planning, case management or disease management preferred. Nursing experience in home services, ambulatory services working with high-risk patients beneficial.
* 2 Years Clinical nursing experience preferred.
* Adheres to and practices in alignment with contemporary standards of care as established by leading professional organizations, including but not limited to the American Academy of Ambulatory Care Nursing (AAACN), the American Case Management Association (ACMA), and the Case Management Society of America (CMSA).
* Interacts with and contributes to professional development of peers and other health care providers as colleagues. Shares knowledge and provides feedback with peers to contribute to an environment supportive of clinical education.
* Knowledge of InterQual or MCG criteria preferred.
* Clinical certification, such as case management certification, is beneficial.
* Able to communicate and work collaboratively with a range of stakeholders and team members.
* Knowledge of community resources.
* Experience with Microsoft Office Suite.
* Strong interpersonal and oral communication skills.
* Strong computer and data entry skills.
* Experience with Electronic Medical Record (EMR) platform preferred.
* Proven leadership skills.
* Ability to work independently, setting priorities to coordinate care plan efficiently.
* Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Required And
* Certified Case Manager (CCM?) - Commission for Case Manager Certification (CCMC) Preferred Or
* Ambulatory Care Nursing (RN-BC) - American Nurses Credentialing Center (ANCC) Preferred And
* BLS - Basic Life Support (CPR and AED) - American Heart Association (AHA) Required
Benefits (for full and part time positions):
* Premium pay for eligible employees.
* Career Pathways to Promote Professional Growth and Development
* Various Medical, Dental, and Vision options
* Tuition Reimbursement
* Free Parking at designated locations
* Wellness Program Savings Plan
* Health Savings Account Options
* Retirement Options with Company Match
* Paid Time Off
* Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disabil
$40.45 - $62.70 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
* Position: RN Patient Care Navigator
* Location: Skokie, IL
* Full Time: 40 hours
* Hours: Monday-Friday, 8:00a-4:30p rotating every 3rd weekend
* I winter holiday (Thanksgiving, Christmas, New Year) and 1 summer (Labor Day, July 4th, Memorial Day) coverage
* Required Travel: Highland Park, Glenbrook, Evanston, Swedish based on clinical needs, less than 1%
A Brief Overview:
The RN Transitional Care Navigator (Population Health) is responsible for the case management, care coordination management, and utilization management of his/her population of patients across multiple care levels and settings. Serves as a catalyst to promote patients understanding their diagnosis, treatment options, and available resources and ensure that they are connected with the optimal resources across the continuum of care. This role will coordinate and facilitate smooth and safe care transitions while ensuring quality cost-effective patient outcomes. Serves as a liaison between their patient population and all other providers. Will be responsible for key metrics of success, which include improving the overall cost of care, length of stay optimization, reduction in excess days, reduction in SNF utilization and improvement in SNF care transitions, reduction in 30-day readmission rate and ED utilization.
What you will do:
* Guides high-risk patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patients with navigating the continuum of care. Eliminates barriers to patient's access to health care services and facilitates continuity of care/care coordination.
* Establishes and documents an individualized plan of care for assigned patients using evidence-based treatment guidelines considering the patients individual health goals with a focus on wellness, health management, disease prevention and chronic disease management.
* Partners with the healthcare team to ensure clinical decision-making, implementation of recommendations, and discharge planning are timely and appropriate.
* Performs daily coordination between multiple departments, multi-disciplinary team, medical clinics, and community outreach to gain knowledge of patient, assure patient safety, smooth transitions of care, and manage utilization and total cost of care.
* Acts as advisor/educator by partnering with social work in providing emotional support including goals of care and counseling. Provides and/or arranges clinical education including medication management, community resources, financial resources, and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making.
* Facilitates appointments for appropriate consultations and support services within established protocols
* Completes Utilization Management for assigned patients.
* Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness of admissions and continued stays and documents findings based on Department standards.
* Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
* May need to travel to visit the patient at home from time to time.
* Available to his/her assigned patient population and participates as part of a call coverage structure.
* Participates in the collection and analysis of data to identify under/over utilization; improve resource consumption; promote potential reduction in cost; and enhance quality of care consistent with organization strategic goals and objectives.
*
What you will need:
* Bachelors Degree Health Administration Required Or
* Bachelors Degree Nursing Required
* 3 Years Utilization review, discharge planning, case management or disease management preferred. Nursing experience in home services, ambulatory services working with high-risk patients beneficial.
* 2 Years Clinical nursing experience preferred.
* Adheres to and practices in alignment with contemporary standards of care as established by leading professional organizations, including but not limited to the American Academy of Ambulatory Care Nursing (AAACN), the American Case Management Association (ACMA), and the Case Management Society of America (CMSA).
* Interacts with and contributes to professional development of peers and other health care providers as colleagues. Shares knowledge and provides feedback with peers to contribute to an environment supportive of clinical education.
* Knowledge of InterQual or MCG criteria preferred.
* Clinical certification, such as case management certification, is beneficial.
* Able to communicate and work collaboratively with a range of stakeholders and team members.
* Knowledge of community resources.
* Experience with Microsoft Office Suite.
* Strong interpersonal and oral communication skills.
* Strong computer and data entry skills.
* Experience with Electronic Medical Record (EMR) platform preferred.
* Proven leadership skills.
* Ability to work independently, setting priorities to coordinate care plan efficiently.
* Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Required And
* Certified Case Manager (CCM?) - Commission for Case Manager Certification (CCMC) Preferred Or
* Ambulatory Care Nursing (RN-BC) - American Nurses Credentialing Center (ANCC) Preferred And
* BLS - Basic Life Support (CPR and AED) - American Heart Association (AHA) Required
Benefits (for full and part time positions):
* Premium pay for eligible employees.
* Career Pathways to Promote Professional Growth and Development
* Various Medical, Dental, and Vision options
* Tuition Reimbursement
* Free Parking at designated locations
* Wellness Program Savings Plan
* Health Savings Account Options
* Retirement Options with Company Match
* Paid Time Off
* Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disabil
Not Specified
W
Registered Nurse (RN) - Care Coordinator - Full-Time Day Shift
Salary not disclosed
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.
Work Shift
Day (United States of America)
Job Summary: Wellstar North Fulton Hospital has an opportunity for a RN Care Coordinator. Full-time Day shift
The Care Coordinator RN (CC RN) is responsible for assessing transitional care needs, coordinating care across the continuum, and engaging with patient and family to assure care needs are met. The CC RN plans effectively to meet the patient's needs, manage the length of stay and promote efficient utilization of resources. Overall, the role integrates and coordinates care facilitation, care progression and transitional care planning functions.
Specific functions within this role include:
Psychosocial and functional status assessment, transitional care planning, clinical care progression, facilitate patient/family care conferences, participate in interdisciplinary rounds, and patient/family education
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs, psychosocial needs, any social determinants of health needs, goals/outcome attainment and continued care needs
Assures that the patient is progressing towards their discharge goal and assists to alleviate barriers
Seeks consultation from appropriate disciplines/departments as required to proactively identify and resolve delays to expedite care and facilitate discharge.
May have other duties assigned
Core Responsibilities and Essential Functions:
Assessment
* Based on preliminary screening of patients, initiates assessment of patients chronic disease management needs and psychosocial risk factors and availability of resources to assist upon discharge.
* Partners with the PAS, financial counselor and/or UM nurse to assess insurance and coverage requirements for all payers to ensure adherence to those requirements.
* Collaborates with the patient and family, along with the physician(s) and other members of the care team to fully establish and support both the patients care progression and discharge plans..
* Meets with physicians and care team routinely to collaborate on timely and efficient patient management.
Disposition Planning
* Manages all aspects of discharge planning for assigned patients.
* Implements discharge planning timely and provides resources in an efficient manner.
* Meets with patient/family to assess needs and develop an individualized discharge plan in collaboration with physicians.
* Identifies and documents barriers for timely disposition.
* Ensures/maintains discharge plan consensus with patient/family, physicians, care teams and payers.
* Responds to referrals for patients post-acute needs from physicians and the care team.
* Participates in Interdisciplinary Rounds with the patients care team to confirm estimated date of discharge and make recommendations for best level of care transition at discharge.
* Initiates/facilitates post-acute referrals through departmental processes for timely transition to the next level of care.
* Refer appropriate cases for social work intervention based on departmental protocol.
* Allows for any cultural or religious beliefs in providing service and continuity of care.
Care Progression
* Collaborates with physicians and care team to facilitate communication regarding patients care progression to ensure timely and efficient delivery of care.
* Proactively identifies delays/obstacles in diagnostic or treatments within the plan of care which can lead to discharge delays.
* Identities and discusses with physician the medical necessity for inpatient testing that may be more appropriate in the outpatient setting.
* Actively works to resolve barriers to discharge and engages/escalates barriers to discharge to the appropriate leader for efficient resolution
Documentation
* Initial clinical/psychosocial assessment completed and documented in medical record.
* Ensure all records are up-to-date and documentation is clear and concise.
* Ensure timely and accurate documentation in progress notes of interactions with patient/family, physicians, care team, and community partners as it pertains to the patients discharge plan.
* Accounts for and indicates all services arranged/delivered in electronic medical record.
* Track avoidable days and report trends that lead to undesired outcomes.
Professional Development and Initiative
* Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education.
* Supports department-based goals which contribute to the success of the organization.
* Serves as a preceptor and/or mentor for student interns (if appropriate)
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.
Required Minimum Education:
Associate's Degree in Nursing from an accredited school of nursing with a Georgia RN License Required
Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.
- Reg Nurse (Single State) or RN - Multi-state Compact
- Basic Life Support or BLS - Instructor
Additional License(s) and Certification(s):
Required Minimum Experience:
Minimum 1 year nursing experience in the acute care setting. Required
Required Minimum Skills:
Excellent written and verbal communication skill.
Must possess maturity, self-confidence, objectivity, and positive attitude.
Self-directed with the ability to function well under stress, handle change, and function in a fast-paced environment
Strong assessment, interview, organizational and problem-solving skills.
Knowledge regarding local, state and federal regulations required.
Knowledge of community and state-wide resources and programs.
Ability to work collaboratively with physicians, members of the care team, and the patient/family to assist with progression of care through their transition to the next level of care.
Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.
Work Shift
Day (United States of America)
Job Summary: Wellstar North Fulton Hospital has an opportunity for a RN Care Coordinator. Full-time Day shift
The Care Coordinator RN (CC RN) is responsible for assessing transitional care needs, coordinating care across the continuum, and engaging with patient and family to assure care needs are met. The CC RN plans effectively to meet the patient's needs, manage the length of stay and promote efficient utilization of resources. Overall, the role integrates and coordinates care facilitation, care progression and transitional care planning functions.
Specific functions within this role include:
Psychosocial and functional status assessment, transitional care planning, clinical care progression, facilitate patient/family care conferences, participate in interdisciplinary rounds, and patient/family education
Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs, psychosocial needs, any social determinants of health needs, goals/outcome attainment and continued care needs
Assures that the patient is progressing towards their discharge goal and assists to alleviate barriers
Seeks consultation from appropriate disciplines/departments as required to proactively identify and resolve delays to expedite care and facilitate discharge.
May have other duties assigned
Core Responsibilities and Essential Functions:
Assessment
* Based on preliminary screening of patients, initiates assessment of patients chronic disease management needs and psychosocial risk factors and availability of resources to assist upon discharge.
* Partners with the PAS, financial counselor and/or UM nurse to assess insurance and coverage requirements for all payers to ensure adherence to those requirements.
* Collaborates with the patient and family, along with the physician(s) and other members of the care team to fully establish and support both the patients care progression and discharge plans..
* Meets with physicians and care team routinely to collaborate on timely and efficient patient management.
Disposition Planning
* Manages all aspects of discharge planning for assigned patients.
* Implements discharge planning timely and provides resources in an efficient manner.
* Meets with patient/family to assess needs and develop an individualized discharge plan in collaboration with physicians.
* Identifies and documents barriers for timely disposition.
* Ensures/maintains discharge plan consensus with patient/family, physicians, care teams and payers.
* Responds to referrals for patients post-acute needs from physicians and the care team.
* Participates in Interdisciplinary Rounds with the patients care team to confirm estimated date of discharge and make recommendations for best level of care transition at discharge.
* Initiates/facilitates post-acute referrals through departmental processes for timely transition to the next level of care.
* Refer appropriate cases for social work intervention based on departmental protocol.
* Allows for any cultural or religious beliefs in providing service and continuity of care.
Care Progression
* Collaborates with physicians and care team to facilitate communication regarding patients care progression to ensure timely and efficient delivery of care.
* Proactively identifies delays/obstacles in diagnostic or treatments within the plan of care which can lead to discharge delays.
* Identities and discusses with physician the medical necessity for inpatient testing that may be more appropriate in the outpatient setting.
* Actively works to resolve barriers to discharge and engages/escalates barriers to discharge to the appropriate leader for efficient resolution
Documentation
* Initial clinical/psychosocial assessment completed and documented in medical record.
* Ensure all records are up-to-date and documentation is clear and concise.
* Ensure timely and accurate documentation in progress notes of interactions with patient/family, physicians, care team, and community partners as it pertains to the patients discharge plan.
* Accounts for and indicates all services arranged/delivered in electronic medical record.
* Track avoidable days and report trends that lead to undesired outcomes.
Professional Development and Initiative
* Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education.
* Supports department-based goals which contribute to the success of the organization.
* Serves as a preceptor and/or mentor for student interns (if appropriate)
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.
Required Minimum Education:
Associate's Degree in Nursing from an accredited school of nursing with a Georgia RN License Required
Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.
- Reg Nurse (Single State) or RN - Multi-state Compact
- Basic Life Support or BLS - Instructor
Additional License(s) and Certification(s):
Required Minimum Experience:
Minimum 1 year nursing experience in the acute care setting. Required
Required Minimum Skills:
Excellent written and verbal communication skill.
Must possess maturity, self-confidence, objectivity, and positive attitude.
Self-directed with the ability to function well under stress, handle change, and function in a fast-paced environment
Strong assessment, interview, organizational and problem-solving skills.
Knowledge regarding local, state and federal regulations required.
Knowledge of community and state-wide resources and programs.
Ability to work collaboratively with physicians, members of the care team, and the patient/family to assist with progression of care through their transition to the next level of care.
Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.
permanent
W
Care Coordinator-RN
🏢 WellStar Health System
Salary not disclosed
How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.
Work Shift
Job Summary:
The Care Coordinator RN (CC RN) is responsible for assessing transitional care needs, coordinating care across the continuum, and engaging with patient and family to assure care needs are met. The CC RN plans effectively to meet the patient's needs, manage the length of stay and promote efficient utilization of resources. Overall, the role integrates and coordinates care facilitation, care progression and transitional care planning functions. Specific functions within this role include: Psychosocial and functional status assessment, transitional care planning, clinical care progression, facilitate patient/family care conferences, participate in interdisciplinary rounds, and patient/family education Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs, psychosocial needs, any social determinants of health needs, goals/outcome attainment and continued care needs Assures that the patient is progressing towards their discharge goal and assists to alleviate barriers Seeks consultation from appropriate disciplines/departments as required to proactively identify and resolve delays to expedite care and facilitate discharge. May have other duties assigned
Core Responsibilities and Essential Functions:
Assessment * Based on preliminary screening of patients, initiates assessment of patients chronic disease management needs and psychosocial risk factors and availability of resources to assist upon discharge. * Partners with the PAS, financial counselor and/or UM nurse to assess insurance and coverage requirements for all payers to ensure adherence to those requirements. * Collaborates with the patient and family, along with the physician(s) and other members of the care team to fully establish and support both the patients care progression and discharge plans.. * Meets with physicians and care team routinely to collaborate on timely and efficient patient management. Disposition Planning * Manages all aspects of discharge planning for assigned patients. * Implements discharge planning timely and provides resources in an efficient manner. * Meets with patient/family to assess needs and develop an individualized discharge plan in collaboration with physicians. * Identifies and documents barriers for timely disposition. * Ensures/maintains discharge plan consensus with patient/family, physicians, care teams and payers. * Responds to referrals for patients post-acute needs from physicians and the care team. * Participates in Interdisciplinary Rounds with the patients care team to confirm estimated date of discharge and make recommendations for best level of care transition at discharge. * Initiates/facilitates post-acute referrals through departmental processes for timely transition to the next level of care. * Refer appropriate cases for social work intervention based on departmental protocol. * Allows for any cultural or religious beliefs in providing service and continuity of care. Care Progression * Collaborates with physicians and care team to facilitate communication regarding patients care progression to ensure timely and efficient delivery of care. * Proactively identifies delays/obstacles in diagnostic or treatments within the plan of care which can lead to discharge delays. * Identities and discusses with physician the medical necessity for inpatient testing that may be more appropriate in the outpatient setting. * Actively works to resolve barriers to discharge and engages/escalates barriers to discharge to the appropriate leader for efficient resolution Documentation * Initial clinical/psychosocial assessment completed and documented in medical record. * Ensure all records are up-to-date and documentation is clear and concise. * Ensure timely and accurate documentation in progress notes of interactions with patient/family, physicians, care team, and community partners as it pertains to the patients discharge plan. * Accounts for and indicates all services arranged/delivered in electronic medical record. * Track avoidable days and report trends that lead to undesired outcomes. Professional Development and Initiative * Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education. * Supports department-based goals which contribute to the success of the organization. * Serves as a preceptor and/or mentor for student interns (if appropriate) Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.
Required Minimum Education:
- Associates Nursing or Diploma (Nurse) Nursing or Bachelors Nursing-Preferred
Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.
- RN - Reg Nurse (Single State) or RN-COMPACT - RN - Multi-state Compact
- BLS - Basic Life Support or ARC-BLS - Amer Red Cross Basic Life Support or BLS-I - Basic Life Support - Instructor
Additional License(s) and Certification(s):
Required Minimum Experience:
Minimum 1 year nursing experience in the acute care setting. Required
Required Minimum Skills:
Excellent written and verbal communication skill. Must possess maturity, self-confidence, objectivity, and positive attitude. Self-directed with the ability to function well under stress, handle change, and function in a fast-paced environment Strong assessment, interview, organizational and problem-solving skills. Knowledge regarding local, state and federal regulations required. Knowledge of community and state-wide resources and programs. Ability to work collaboratively with physicians, members of the care team, and the patient/family to assist with progression of care through their transition to the next level of care.
Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.
Work Shift
Job Summary:
The Care Coordinator RN (CC RN) is responsible for assessing transitional care needs, coordinating care across the continuum, and engaging with patient and family to assure care needs are met. The CC RN plans effectively to meet the patient's needs, manage the length of stay and promote efficient utilization of resources. Overall, the role integrates and coordinates care facilitation, care progression and transitional care planning functions. Specific functions within this role include: Psychosocial and functional status assessment, transitional care planning, clinical care progression, facilitate patient/family care conferences, participate in interdisciplinary rounds, and patient/family education Collaborates effectively with the utilization review nurse, patient's physicians and the interdisciplinary care team to provide a comprehensive assessment of the patient's medical care needs, psychosocial needs, any social determinants of health needs, goals/outcome attainment and continued care needs Assures that the patient is progressing towards their discharge goal and assists to alleviate barriers Seeks consultation from appropriate disciplines/departments as required to proactively identify and resolve delays to expedite care and facilitate discharge. May have other duties assigned
Core Responsibilities and Essential Functions:
Assessment * Based on preliminary screening of patients, initiates assessment of patients chronic disease management needs and psychosocial risk factors and availability of resources to assist upon discharge. * Partners with the PAS, financial counselor and/or UM nurse to assess insurance and coverage requirements for all payers to ensure adherence to those requirements. * Collaborates with the patient and family, along with the physician(s) and other members of the care team to fully establish and support both the patients care progression and discharge plans.. * Meets with physicians and care team routinely to collaborate on timely and efficient patient management. Disposition Planning * Manages all aspects of discharge planning for assigned patients. * Implements discharge planning timely and provides resources in an efficient manner. * Meets with patient/family to assess needs and develop an individualized discharge plan in collaboration with physicians. * Identifies and documents barriers for timely disposition. * Ensures/maintains discharge plan consensus with patient/family, physicians, care teams and payers. * Responds to referrals for patients post-acute needs from physicians and the care team. * Participates in Interdisciplinary Rounds with the patients care team to confirm estimated date of discharge and make recommendations for best level of care transition at discharge. * Initiates/facilitates post-acute referrals through departmental processes for timely transition to the next level of care. * Refer appropriate cases for social work intervention based on departmental protocol. * Allows for any cultural or religious beliefs in providing service and continuity of care. Care Progression * Collaborates with physicians and care team to facilitate communication regarding patients care progression to ensure timely and efficient delivery of care. * Proactively identifies delays/obstacles in diagnostic or treatments within the plan of care which can lead to discharge delays. * Identities and discusses with physician the medical necessity for inpatient testing that may be more appropriate in the outpatient setting. * Actively works to resolve barriers to discharge and engages/escalates barriers to discharge to the appropriate leader for efficient resolution Documentation * Initial clinical/psychosocial assessment completed and documented in medical record. * Ensure all records are up-to-date and documentation is clear and concise. * Ensure timely and accurate documentation in progress notes of interactions with patient/family, physicians, care team, and community partners as it pertains to the patients discharge plan. * Accounts for and indicates all services arranged/delivered in electronic medical record. * Track avoidable days and report trends that lead to undesired outcomes. Professional Development and Initiative * Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education. * Supports department-based goals which contribute to the success of the organization. * Serves as a preceptor and/or mentor for student interns (if appropriate) Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.
Required Minimum Education:
- Associates Nursing or Diploma (Nurse) Nursing or Bachelors Nursing-Preferred
Required Minimum License(s) and Certification(s):
All certifications are required upon hire unless otherwise stated.
- RN - Reg Nurse (Single State) or RN-COMPACT - RN - Multi-state Compact
- BLS - Basic Life Support or ARC-BLS - Amer Red Cross Basic Life Support or BLS-I - Basic Life Support - Instructor
Additional License(s) and Certification(s):
Required Minimum Experience:
Minimum 1 year nursing experience in the acute care setting. Required
Required Minimum Skills:
Excellent written and verbal communication skill. Must possess maturity, self-confidence, objectivity, and positive attitude. Self-directed with the ability to function well under stress, handle change, and function in a fast-paced environment Strong assessment, interview, organizational and problem-solving skills. Knowledge regarding local, state and federal regulations required. Knowledge of community and state-wide resources and programs. Ability to work collaboratively with physicians, members of the care team, and the patient/family to assist with progression of care through their transition to the next level of care.
Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.
Not Specified
Licensed Nurse Care Coordinator Senior - Population Health Admin
✦ New
Salary not disclosed
Description Summary: An LVN/ LPN plays a crucial role in managing patient care and ensuring continuity of services.
The Care Coordinator is responsible for making telephonic outreaches to members attributed to our value-based contacts.
They support the ACO and CIN network providers and practices in successfully meeting quality improvement initiatives, monitoring standards of care and managing high risk multi morbidity patient populations across CHRISTUS Health ministries.
The role focuses on improving quality care gaps, promoting preventive care, and improving patient outcomes.
Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Mentor, train and support the team of care coordinators, ensuring high-quality care and adherence to best practices.
Assist with work assignments and development of new work processes as needed.
Coordinate and assist with associate onboarding.
Create education material for training.
Monitor and ensure compliance with all regulatory requirements, organizational policies, standing delegated orders and protocols.
Identify quality gaps and risk adjustment gaps.
Participate in Quality Improvement Programs as indicated.
Attend learning sessions and share information learned with team members.
Assist in the development of tools, education, and workflow processes to assist the network in meeting CMS, ACO, documentation, and payor quality initiatives.
Conducts internal review audits to facilitate feedback for documentation and efficiency of the care coordination team.
Support Primary Care Providers and assist patients in scheduling preventative screenings and appropriate appointments.
Maintain ongoing communication with healthcare providers through various tools and meetings.
Monitor value-based care quality performance and pulls reports to identify open care gaps.
Conducts telephonic outreach on behalf of providers to close care gaps & address medication adherence to facilitate star rating and quality performance.
Providing counseling and health education to patients and families, using appropriate materials and standardized protocols.
Serve as a subject matter expert in care transitions & quality metrics.
Assist in educating practice staff on quality, payor, and government program requirements.
Communicate resources and services available to patients through the continuum of care.
Escalate health concerns to Primary Care providers and place referrals to appropriate care team members, i.e., Nurse Navigation, CHW, etc.
Develop professional working relationships with ACO and CIN network providers, practice managers, and their staff to collaboratively manage follow-up care and improve overall health and wellness.
Conduct in-person and virtual meetings with practice managers, staff, providers and managers to communicate program goals, results, and provide education.
Document relevant, comprehensive information and data using standard assessment tools.
Maintain patient chart compliance through proper documentation and updated: preventative screenings, medical history, medication, and immunizations.
Unburden primary care providers by placing approved orders for labs and other screenings as per the Standing Delegated orders.
Perform Transition of Care calls on patients transitioning from an inpatient stay to home, or emergency department encounter to identify the need for a follow-up appointment, community resource needs, scheduling follow-up appointments, reviewing discharge instructions, and medications.
Utilizing clinical judgment and problem-solving skills to coordinate appropriate care with physicians and Nurse Navigation.
Prepare and maintain Transitions of Care and Care Management reports and provide periodic updates to network leaders.
Must have strong leadership, exceptional oral communication skills, strong organizational and analytical skills, ability to adapt to change and motivate a team.
Must have a strong ability to multi-task and coordinate multiple projects.
Perform other duties as assigned.
Job Requirements: Education/Skills
- High School Diploma required.
Experience
- Minimum of 3 years of clinical or home health experience required.
- 5 years supporting value-based care programs, accountable care organizations, or HEDIS
- Knowledge of government programs (CMS), accountable care organizations (ACOs), HEDIS, and experience with payor cost sharing initiatives preferred.
- Knowledge of physician office practice operations and 3 years of experience in a physician practice is preferred.
- Proficiency in keyboarding and EHR systems, primarily Epic.
Licenses, Registrations, or Certifications
- LVN/ LPN in the state of employment and/or compact licensure required.
In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.
Work Schedule: 8AM
- 5PM Monday-Friday Work Type: Full Time5c143e31-5e48-4549-b638-05792d185386
The Care Coordinator is responsible for making telephonic outreaches to members attributed to our value-based contacts.
They support the ACO and CIN network providers and practices in successfully meeting quality improvement initiatives, monitoring standards of care and managing high risk multi morbidity patient populations across CHRISTUS Health ministries.
The role focuses on improving quality care gaps, promoting preventive care, and improving patient outcomes.
Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
Mentor, train and support the team of care coordinators, ensuring high-quality care and adherence to best practices.
Assist with work assignments and development of new work processes as needed.
Coordinate and assist with associate onboarding.
Create education material for training.
Monitor and ensure compliance with all regulatory requirements, organizational policies, standing delegated orders and protocols.
Identify quality gaps and risk adjustment gaps.
Participate in Quality Improvement Programs as indicated.
Attend learning sessions and share information learned with team members.
Assist in the development of tools, education, and workflow processes to assist the network in meeting CMS, ACO, documentation, and payor quality initiatives.
Conducts internal review audits to facilitate feedback for documentation and efficiency of the care coordination team.
Support Primary Care Providers and assist patients in scheduling preventative screenings and appropriate appointments.
Maintain ongoing communication with healthcare providers through various tools and meetings.
Monitor value-based care quality performance and pulls reports to identify open care gaps.
Conducts telephonic outreach on behalf of providers to close care gaps & address medication adherence to facilitate star rating and quality performance.
Providing counseling and health education to patients and families, using appropriate materials and standardized protocols.
Serve as a subject matter expert in care transitions & quality metrics.
Assist in educating practice staff on quality, payor, and government program requirements.
Communicate resources and services available to patients through the continuum of care.
Escalate health concerns to Primary Care providers and place referrals to appropriate care team members, i.e., Nurse Navigation, CHW, etc.
Develop professional working relationships with ACO and CIN network providers, practice managers, and their staff to collaboratively manage follow-up care and improve overall health and wellness.
Conduct in-person and virtual meetings with practice managers, staff, providers and managers to communicate program goals, results, and provide education.
Document relevant, comprehensive information and data using standard assessment tools.
Maintain patient chart compliance through proper documentation and updated: preventative screenings, medical history, medication, and immunizations.
Unburden primary care providers by placing approved orders for labs and other screenings as per the Standing Delegated orders.
Perform Transition of Care calls on patients transitioning from an inpatient stay to home, or emergency department encounter to identify the need for a follow-up appointment, community resource needs, scheduling follow-up appointments, reviewing discharge instructions, and medications.
Utilizing clinical judgment and problem-solving skills to coordinate appropriate care with physicians and Nurse Navigation.
Prepare and maintain Transitions of Care and Care Management reports and provide periodic updates to network leaders.
Must have strong leadership, exceptional oral communication skills, strong organizational and analytical skills, ability to adapt to change and motivate a team.
Must have a strong ability to multi-task and coordinate multiple projects.
Perform other duties as assigned.
Job Requirements: Education/Skills
- High School Diploma required.
Experience
- Minimum of 3 years of clinical or home health experience required.
- 5 years supporting value-based care programs, accountable care organizations, or HEDIS
- Knowledge of government programs (CMS), accountable care organizations (ACOs), HEDIS, and experience with payor cost sharing initiatives preferred.
- Knowledge of physician office practice operations and 3 years of experience in a physician practice is preferred.
- Proficiency in keyboarding and EHR systems, primarily Epic.
Licenses, Registrations, or Certifications
- LVN/ LPN in the state of employment and/or compact licensure required.
In accordance with the CHRISTUS Health License, Certification and Registration Verification Policy, all Associates are required to obtain the required certifications for their respective positions within the designated time frame.
Work Schedule: 8AM
- 5PM Monday-Friday Work Type: Full Time5c143e31-5e48-4549-b638-05792d185386
Not Specified
RN Patient Care Navigator- Oncology
✦ New 🏢 Endeavor Health
Salary not disclosed
Hourly Pay Range:
$40.45 - $62.70 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
- Sign on bonus: (if applicable)
- Position:
- Location: [City, IL]
- Full Time/Part Time: [Full Time / Part Time]
- Hours: Monday-Friday, [hours and flexible work schedules]
- Required Travel:
A Brief Overview:
The RN Transitional Care Navigator (Population Health) is responsible for the case management, care coordination management, and utilization management of his/her population of patients across multiple care levels and settings. Serves as a catalyst to promote patients understanding their diagnosis, treatment options, and available resources and ensure that they are connected with the optimal resources across the continuum of care. This role will coordinate and facilitate smooth and safe care transitions while ensuring quality cost-effective patient outcomes. Serves as a liaison between their patient population and all other providers. Will be responsible for key metrics of success, which include improving the overall cost of care, length of stay optimization, reduction in excess days, reduction in SNF utilization and improvement in SNF care transitions, reduction in 30-day readmission rate and ED utilization.
What you will do:
- Guides high-risk patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patients with navigating the continuum of care. Eliminates barriers to patient's access to health care services and facilitates continuity of care/care coordination.
- Establishes and documents an individualized plan of care for assigned patients using evidence-based treatment guidelines considering the patients individual health goals with a focus on wellness, health management, disease prevention and chronic disease management.
- Partners with the healthcare team to ensure clinical decision-making, implementation of recommendations, and discharge planning are timely and appropriate.
- Performs daily coordination between multiple departments, multi-disciplinary team, medical clinics, and community outreach to gain knowledge of patient, assure patient safety, smooth transitions of care, and manage utilization and total cost of care.
- Acts as advisor/educator by partnering with social work in providing emotional support including goals of care and counseling. Provides and/or arranges clinical education including medication management, community resources, financial resources, and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making.
- Facilitates appointments for appropriate consultations and support services within established protocols
- Completes Utilization Management for assigned patients.
- Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness of admissions and continued stays and documents findings based on Department standards.
- Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
- May need to travel to visit the patient at home from time to time.
- Available to his/her assigned patient population and participates as part of a call coverage structure.
- Participates in the collection and analysis of data to identify under/over utilization; improve resource consumption; promote potential reduction in cost; and enhance quality of care consistent with organization strategic goals and objectives.
What you will need:
- Bachelors Degree Health Administration Required Or
- Bachelors Degree Nursing Required
- 3 Years Utilization review, discharge planning, case management or disease management preferred. Nursing experience in home services, ambulatory services working with high-risk patients beneficial.
- 2 Years Clinical nursing experience preferred.
- Adheres to and practices in alignment with contemporary standards of care as established by leading professional organizations, including but not limited to the American Academy of Ambulatory Care Nursing (AAACN), the American Case Management Association (ACMA), and the Case Management Society of America (CMSA).
- Interacts with and contributes to professional development of peers and other health care providers as colleagues. Shares knowledge and provides feedback with peers to contribute to an environment supportive of clinical education.
- Knowledge of InterQual or MCG criteria preferred.
- Clinical certification, such as case management certification, is beneficial.
- Able to communicate and work collaboratively with a range of stakeholders and team members.
- Knowledge of community resources.
- Experience with Microsoft Office Suite.
- Strong interpersonal and oral communication skills.
- Strong computer and data entry skills.
- Experience with Electronic Medical Record (EMR) platform preferred.
- Proven leadership skills.
- Ability to work independently, setting priorities to coordinate care plan efficiently.
- Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Required And
- Certified Case Manager (CCM?) - Commission for Case Manager Certification (CCMC) Preferred Or
- Ambulatory Care Nursing (RN-BC) - American Nurses Credentialing Center (ANCC) Preferred And
- BLS ? Basic Life Support (CPR and AED) - American Heart Association (AHA) Required
Benefits:
- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off
- Community Involvement Opportunities
$40.45 - $62.70 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
- Sign on bonus: (if applicable)
- Position:
- Location: [City, IL]
- Full Time/Part Time: [Full Time / Part Time]
- Hours: Monday-Friday, [hours and flexible work schedules]
- Required Travel:
A Brief Overview:
The RN Transitional Care Navigator (Population Health) is responsible for the case management, care coordination management, and utilization management of his/her population of patients across multiple care levels and settings. Serves as a catalyst to promote patients understanding their diagnosis, treatment options, and available resources and ensure that they are connected with the optimal resources across the continuum of care. This role will coordinate and facilitate smooth and safe care transitions while ensuring quality cost-effective patient outcomes. Serves as a liaison between their patient population and all other providers. Will be responsible for key metrics of success, which include improving the overall cost of care, length of stay optimization, reduction in excess days, reduction in SNF utilization and improvement in SNF care transitions, reduction in 30-day readmission rate and ED utilization.
What you will do:
- Guides high-risk patient and family through the health system from diagnosis, testing, treatment and follow-up care to assist patients with navigating the continuum of care. Eliminates barriers to patient's access to health care services and facilitates continuity of care/care coordination.
- Establishes and documents an individualized plan of care for assigned patients using evidence-based treatment guidelines considering the patients individual health goals with a focus on wellness, health management, disease prevention and chronic disease management.
- Partners with the healthcare team to ensure clinical decision-making, implementation of recommendations, and discharge planning are timely and appropriate.
- Performs daily coordination between multiple departments, multi-disciplinary team, medical clinics, and community outreach to gain knowledge of patient, assure patient safety, smooth transitions of care, and manage utilization and total cost of care.
- Acts as advisor/educator by partnering with social work in providing emotional support including goals of care and counseling. Provides and/or arranges clinical education including medication management, community resources, financial resources, and expert guidance to patients and families to promote their ability to understand and meaningfully participate in the healthcare process and personal decision-making.
- Facilitates appointments for appropriate consultations and support services within established protocols
- Completes Utilization Management for assigned patients.
- Applies Milliman Care Guidelines (Indicia) criteria to monitor appropriateness of admissions and continued stays and documents findings based on Department standards.
- Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
- May need to travel to visit the patient at home from time to time.
- Available to his/her assigned patient population and participates as part of a call coverage structure.
- Participates in the collection and analysis of data to identify under/over utilization; improve resource consumption; promote potential reduction in cost; and enhance quality of care consistent with organization strategic goals and objectives.
What you will need:
- Bachelors Degree Health Administration Required Or
- Bachelors Degree Nursing Required
- 3 Years Utilization review, discharge planning, case management or disease management preferred. Nursing experience in home services, ambulatory services working with high-risk patients beneficial.
- 2 Years Clinical nursing experience preferred.
- Adheres to and practices in alignment with contemporary standards of care as established by leading professional organizations, including but not limited to the American Academy of Ambulatory Care Nursing (AAACN), the American Case Management Association (ACMA), and the Case Management Society of America (CMSA).
- Interacts with and contributes to professional development of peers and other health care providers as colleagues. Shares knowledge and provides feedback with peers to contribute to an environment supportive of clinical education.
- Knowledge of InterQual or MCG criteria preferred.
- Clinical certification, such as case management certification, is beneficial.
- Able to communicate and work collaboratively with a range of stakeholders and team members.
- Knowledge of community resources.
- Experience with Microsoft Office Suite.
- Strong interpersonal and oral communication skills.
- Strong computer and data entry skills.
- Experience with Electronic Medical Record (EMR) platform preferred.
- Proven leadership skills.
- Ability to work independently, setting priorities to coordinate care plan efficiently.
- Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR) Required And
- Certified Case Manager (CCM?) - Commission for Case Manager Certification (CCMC) Preferred Or
- Ambulatory Care Nursing (RN-BC) - American Nurses Credentialing Center (ANCC) Preferred And
- BLS ? Basic Life Support (CPR and AED) - American Heart Association (AHA) Required
Benefits:
- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off
- Community Involvement Opportunities
Not Specified
Physical Therapist II - Acute Care
Salary not disclosed
Description
Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.
UNC Hospitals Rehabilitation Services is accepting applications for a full-time Acute Care Physical Therapist II position. Supporting our Enhanced Rehabilitation program in the acute hospital setting, the PT II will provide comprehensive consultations and therapeutic interventions to a diverse patient population with varying acuity levels. This person will collaborate directly with the interdisciplinary team to provide exceptional patient-centered care, facilitating functional improvement and discharge planning throughout care transitions.
The selected candidate will serve as a stakeholder, assisting in the implementation and sustainment of unit-based care team models to optimize patient care outcomes and best practices. The PT II will provide clinical supervision and mentorship to other staff and students, assist with facilitating clinical practice development activities, and may supervise support staff. Excellent time management and communication skills are required for this fast-paced environment; clinical experience in acute care is strongly preferred. A strong work ethic and growth-oriented mindset are essential characteristics for interested applicants.
The selected candidate will work 40hr per week with occasional weekend and holiday coverage.
Why UNCH? UNC Hospital has been recognized as a leader in patient experience, providing evidence-based care to patients from a broad geographic area throughout North Carolina. The hospital offers extensive employee incentives, which include competitive benefits and PTO accrual, health reimbursement arrangements, employee discounts, well-being programs, employee assistance programs, tuition reimbursement, legal planning, and retirement planning. Additionally, teammates will receive comprehensive orientation and mentoring, continuing education and specialty certification funds, professional development opportunities, and more.
Summary:
This is complex professional level work involving the evaluation of patient disabilities, planning, and administration of physical therapy treatments. Incumbents are responsible for a specialty area and may supervise support staff. Incumbents complete documentation instruct patients, families, and students and participate in clinical program development and management. Work is performed under general supervision with all treatments being prescribed by a physician. Employees are expected to exercise initiative and discretion in formulating a program of treatments to meet the needs of individual patients. Work is reviewed and evaluated by physicians or therapist supervisors.
Responsibilities:
1. Completes PT documentation in the medical record per department guidelines and completes department records for billing and statistics
2. Evaluates Patient, sets Physical Therapy (PT) treatment goals, devises a PT treatment plan and manages resources needed to perform treatment plan to accomplish the goals set for the patient.
3. Manages PT caseload with efficiency and efficacy
4. Plans and coordinates clinical programs
5. Provides clinical supervision and teaching for multiple students and/or staff. Plans orientation, caseload, and other learning activities. Provides regular feedback and coaching. Evaluates the learner's performance.
Other Information
Other information:
Education Requirements:
● Graduation from an accredited Physical Therapy program.
Licensure/Certification Requirements:
● - Licensed as a Physical Therapist in the state of North Carolina.
● - BLS
Professional Experience Requirements:
● Five (5) years of experience as a licensed Physical Therapist, including one (1) year in the specialty field.
Knowledge/Skills/and Abilities Requirements:
Job Details
Legal Employer: STATE
Entity: UNC Medical Center
Organization Unit: Physical Therapy
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $38.55 - $55.43 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Onsite
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: Yes
This is a State position employed by UNC Health Care System with UNC Health benefits. If, however, you are presently an employee of another North Carolina agency and currently participate in TSERS or the ORP, you will be eligible to continue participating in those plans at UNC Health.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email if you need a reasonable accommodation to search and/or to apply for a career opportunity.
Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.
UNC Hospitals Rehabilitation Services is accepting applications for a full-time Acute Care Physical Therapist II position. Supporting our Enhanced Rehabilitation program in the acute hospital setting, the PT II will provide comprehensive consultations and therapeutic interventions to a diverse patient population with varying acuity levels. This person will collaborate directly with the interdisciplinary team to provide exceptional patient-centered care, facilitating functional improvement and discharge planning throughout care transitions.
The selected candidate will serve as a stakeholder, assisting in the implementation and sustainment of unit-based care team models to optimize patient care outcomes and best practices. The PT II will provide clinical supervision and mentorship to other staff and students, assist with facilitating clinical practice development activities, and may supervise support staff. Excellent time management and communication skills are required for this fast-paced environment; clinical experience in acute care is strongly preferred. A strong work ethic and growth-oriented mindset are essential characteristics for interested applicants.
The selected candidate will work 40hr per week with occasional weekend and holiday coverage.
Why UNCH? UNC Hospital has been recognized as a leader in patient experience, providing evidence-based care to patients from a broad geographic area throughout North Carolina. The hospital offers extensive employee incentives, which include competitive benefits and PTO accrual, health reimbursement arrangements, employee discounts, well-being programs, employee assistance programs, tuition reimbursement, legal planning, and retirement planning. Additionally, teammates will receive comprehensive orientation and mentoring, continuing education and specialty certification funds, professional development opportunities, and more.
Summary:
This is complex professional level work involving the evaluation of patient disabilities, planning, and administration of physical therapy treatments. Incumbents are responsible for a specialty area and may supervise support staff. Incumbents complete documentation instruct patients, families, and students and participate in clinical program development and management. Work is performed under general supervision with all treatments being prescribed by a physician. Employees are expected to exercise initiative and discretion in formulating a program of treatments to meet the needs of individual patients. Work is reviewed and evaluated by physicians or therapist supervisors.
Responsibilities:
1. Completes PT documentation in the medical record per department guidelines and completes department records for billing and statistics
2. Evaluates Patient, sets Physical Therapy (PT) treatment goals, devises a PT treatment plan and manages resources needed to perform treatment plan to accomplish the goals set for the patient.
3. Manages PT caseload with efficiency and efficacy
4. Plans and coordinates clinical programs
5. Provides clinical supervision and teaching for multiple students and/or staff. Plans orientation, caseload, and other learning activities. Provides regular feedback and coaching. Evaluates the learner's performance.
Other Information
Other information:
Education Requirements:
● Graduation from an accredited Physical Therapy program.
Licensure/Certification Requirements:
● - Licensed as a Physical Therapist in the state of North Carolina.
● - BLS
Professional Experience Requirements:
● Five (5) years of experience as a licensed Physical Therapist, including one (1) year in the specialty field.
Knowledge/Skills/and Abilities Requirements:
Job Details
Legal Employer: STATE
Entity: UNC Medical Center
Organization Unit: Physical Therapy
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $38.55 - $55.43 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Onsite
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: Yes
This is a State position employed by UNC Health Care System with UNC Health benefits. If, however, you are presently an employee of another North Carolina agency and currently participate in TSERS or the ORP, you will be eligible to continue participating in those plans at UNC Health.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email if you need a reasonable accommodation to search and/or to apply for a career opportunity.
Not Specified
Acute Care Physical Therapist I
🏢 UNC Health
Salary not disclosed
Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.
UNC Hospitals Rehabilitation Services is accepting applications for a full-time Acute Care Physical Therapist I position.
Supporting our Enhanced Rehabilitation program in the acute hospital setting, the PT I will provide comprehensive consultations and therapeutic interventions to a diverse patient population with varying acuity levels.
This person will collaborate directly with the interdisciplinary team to provide exceptional patient-centered care, facilitating functional improvement and discharge planning throughout care transitions.
The selected candidate will serve as a stakeholder, assisting in the implementation and sustainment of unit-based care team models to optimize patient care outcomes and best practices.
Excellent time management and communication skills are required for this fast-paced environment; clinical experience in acute care is strongly preferred.
A strong work ethic and growth-oriented mindset are essential characteristics for interested applicants.
Why UNCH? UNC Hospital has been recognized as a leader in patient experience, providing evidence-based care to patients from a broad geographic area throughout North Carolina.
The hospital offers extensive employee incentives, which include competitive benefits and PTO accrual, health reimbursement arrangements, employee discounts, well-being programs, employee assistance programs, tuition reimbursement, legal planning, and retirement planning.
Additionally, teammates will receive comprehensive orientation and mentoring, continuing education and specialty certification funds, professional development opportunities, and more.
Summary: This is professional level work involving the evidence- based evaluation of patient disabilities, planning, and administration of physical therapy treatments.
Incumbents complete documentation instruct patients, families, and students and participate in clinical program development and management.
Clinician is expected to have involvement in the areas of continuing education, departmental and community activities, outreach education and role of preceptor to students.
Responsibilities: 1.
Diagnostic Testing
- Administers basic & complex diagnostic tests and evaluations in the area of Physical Therapy for the treatment of mobility disorders and related impairments 2.
Education
- Teach & supervise graduate Physical Therapy students and/or clinical fellows/residents.
Develops or contributes to innovative programs to enhance patient care.
Serves as resource consultant to other clinicians in respective specialty area.
3.
Evaluation of Care
- Analyzes results of diagnostic and or therapeutic testing to establish patient goals and or modify subsequent treatment programs.
Identifies expected patient outcomes.
Communicates relevant information to promote continuity of care.
4.
Implementation Selects and applies current and advanced techniques to provide quality and efficient rehabilitative services.
Provides habilitation/rehabilitation and maintenance of persons with mobility related impairments.
Organizes and prioritizes care according to patient/family needs.
5.
Outreach/Community Involvement-Serves as resource to North Carolina government departments and statewide health professionals in specialty areas.
Presents at local (university/hospital) or state level, participates in community health screening and events.
Participates in the development of new clinical programs to meet emerging needs in conjunction with the clinical specialist and/or department director.
6.
Participation
- Contributes to quality of clinical services through attendance and participation in departmental meetings and in-services.
7.
Quality-Contributes to quality of clinical services through maintenance of valid & reliable records of patient procedures & progress.
Participates in quality improvement initiatives with the clinical specialist and other healthcare professionals.
Participates in continuous quality improvement efforts in conjunction with the department director.
Other Information Other information: Education Requirements: ● Graduation from an accredited Physical Therapy program.
Licensure/Certification Requirements: ●
- Licensed as a Physical Therapist in the state of North Carolina.
●
- BLS Professional Experience Requirements: ● No prior experience required.
Knowledge/Skills/and Abilities Requirements: Job Details Legal Employer: STATE Entity: UNC Medical Center Organization Unit: Physical Therapy Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $35.87- $51.57 per hour (Hiring Range) Pay offers are determined by experience and internal equity Work Assignment Type: Onsite Work Schedule: Day Job Location of Job: US:NC:Chapel Hill Exempt From Overtime: Exempt: Yes This is a State position employed by UNC Health Care System with UNC Health benefits.
If, however, you are presently an employee of another North Carolina agency and currently participate in TSERS or the ORP, you will be eligible to continue participating in those plans at UNC Health.
Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities.
All interested applicants are invited to apply for career opportunities.
Please email if you need a reasonable accommodation to search and/or to apply for a career opportunity.
permanent
M
Primary Care Physician
✦ New
Salary not disclosed
Our client delivers team-based, value-driven care to medically complex and underserved patients—focusing on outcomes, prevention, and meaningful patient relationships, not volume.
We’re seeking a Lead Physician to provide direct care while leading interdisciplinary teams and driving clinical excellence in the Cincinnati center.
What You’ll Do
Clinical Care
- Provide comprehensive primary care to complex patients
- Manage acute and chronic conditions with a preventive focus
- Support care transitions and reduce avoidable hospital/ER use
- Collaborate with integrated care teams to improve outcomes
Leadership
- Lead and mentor physicians and care teams
- Provide real-time clinical guidance
- Partner with the Medical Director on care quality and strategy
Operations
- Drive quality, utilization, and engagement metrics
- Support population health and value-based care initiatives
What Makes This Role Different
- Smaller panels, deeper patient relationships
- Fully integrated care teams (behavioral health, pharmacy, lab, etc.)
- Focus on whole-person care, including social determinants of health
- Mission-driven culture built on accountability, trust, and teamwork
What You Bring
- Active, unrestricted medical license in the state of Ohio.
- 5+ years of clinical experience and administrative experience leading interdisciplinary teams.
- Leadership and team-based care experience
- Passion for value-based, population health
What We Offer
$300K+ compensation potential + $50K sign-on bonus
Health, dental, vision, and malpractice coverage
401(k), PTO, and relocation assistance
Make a Bigger Impact in Primary Care and help redefine care for the patients who need it most.
Not Specified
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