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Care Coordinator will be instrumental in assisting the department and clinicians in the Ambulatory setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to eligible Medicare Advantage beneficiary. Will monitor opportunities within the Medicare managed group to enhance financial outcomes. Will coordinate the transition of care and the interdisciplinary treatment for Medicare managed patients across the healthcare continuum. Facilitates the delivery of services, evaluates effectiveness, tracks outcomes and functions as the patient advocate to identify and communicate health care needs. Works collaboratively with clinical staff, clinic leadership, and outside agencies in an effort to improve patient outcomes, compliance, and decrease complications.
EDUCATION/EXPERIENCE
Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred. Three years recent, full time hospital experience preferred. Work experience in case management, utilization review, or hospital quality assurance experience is preferred.
LICENSURE/CERTIFICATION
Current license from the Board of Nurse Examiners of the State of Texas to practice as a registered nurse is required. National certification in related field is desirable. Case Manager Certification (CCM, CPHQ, or ANCC) or Certified Diabetes Nurse Educator certification is highly desirable. Must have a current AHA BLS Healthcare Provider or AHA BLS Instructor Provider card.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Functions as an integral member of the physician-led care team that provides primary care including preventive care and on-going health maintenance for selected groups of patients. Participates in the care of well, acutely ill and chronically ill patients.
EDUCATION
BSN is required. Recent patient care experience in transplant or at least one year of experience as a registered nurse is required. National certification in transplant is preferred.
LICENSURE/CERTIFICATION
Must be currently licensed as a Registered Nurse in the State of Texas. Must maintain current AHA BLS or higher. ACLS preferred.
Functions as an integral member of the physician-led care team that provides primary care including preventive care and on-going health maintenance for selected groups of patients. Participates in the care of well, acutely ill and chronically ill patients.
EDUCATION
BSN is required. Recent patient care experience in transplant or at least one year of experience as a registered nurse is required. National certification in transplant is preferred.
LICENSURE/CERTIFICATION
Must be currently licensed as a Registered Nurse in the State of Texas. Must maintain current AHA BLS or higher. ACLS preferred.
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan f care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing is highly preferred. Three to five years nursing experience required (as a Staff nurse II or above). Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred and must be achieved within two years of placement. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred.
National certification (e.g.
CCRN, RNC, CEN, CNOR, OCN, ANCC, CAN, CPAN, CFRN, etc.) in related field is preferred.
Three years recent, full-time hospital experience preferred.
Work experience in case management, utilization review or hospital quality assurance experience is preferred.
Must complete a Clinical Documentation Improvement Course within specified time of hire date.
Current license from the Board of Nurse Examiners of the State of Texas to practice as a registered nurse is required.
National certification in related field is preferred.
Case Manager Certification (CCM or ANCC) is highly desirable.
Graduation from an accredited school of nursing with current RN licensure in the State of Texas, BSN preferred.
National certification (e.g.
CCRN, RNC, CEN, CNOR, OCN, ANCC, CAN, CPAN, CFRN, etc.) in related field is preferred.
Three years recent, full-time hospital experience preferred.
Work experience in case management, utilization review or hospital quality assurance experience is preferred.
Must complete a Clinical Documentation Improvement Course within specified time of hire date.
Current license from the Board of Nurse Examiners of the State of Texas to practice as a registered nurse is required.
National certification in related field is preferred.
Case Manager Certification (CCM or ANCC) is highly desirable.
POSITION SUMMARY/RESPONSIBILITIES
The nurse case manager coordinates, in collaboration with the patient and interdisciplinary team, the treatment/ plan of care for a patient within the acute episode of care. He/she proactively facilitates interventions to assure timely delivery of services, evaluates the effectiveness of interventions, tracks variances and/or barriers in the plan of care, and functions as the patient advocate to identify and communicate health care needs.
EDUCATION/EXPERIENCE
Bachelor's degree in Nursing is highly preferred. Three to five years nursing experience required. Work experience in case management, utilization review or hospital quality is preferred.
LICENSURE/ CERTIFICATIONS
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. An approved case management certification (ACM, CCM or ANCC) is preferred. Current American Heart Association, Basic Cardiac Life Support and/or Health Care Provider card preferred.
Summary:
Responsible for managing, coordinating and integrating all Care Coordination services within CHRISTUS St. Vincent Health System. Provides Care Coordination services to patients based on person-centered acuity and coordinates patient in hospital or clinic setting. Contributes to a cooperative and accountable working relationship with other members of the Care Coordination system staff toward the goal of providing continuous high quality services to patients. Promotes optimal person-centered care that supports and empowers individuals, respects individual choices and meets health care needs of patients. Works side-by-side with clinical leaders in the development and implementation of protocols. May work in traditional clinic setting and/or in a training environment (residency program) or other areas as assigned.
Responsibilities:
- Provides Care Coordination services in the ambulatory setting that supports quality patient care across the continuum.
- Ability to work in a variety of electronic medical records, ability to compile record information into a single patient file. Inputs patient orders from standing protocols and displays above average critical thinking skills.
- Maintains coordination of health care for patients within CSVCG; routinely interacts with physicians, administrators, managers, care coordinators and patients to ensure an integrated continuum of person-centered services and programs.
- Communicates in such a way to promote harmonious interpersonal relationships within and among all settings of care.
- Develops relationships with a variety of community resources to include Skilled Nursing Facility (SNF), rehab, Long Term Acute Care (LTAC), home health, hospice, palliative care, and other essential community support agencies. Maintains good working knowledge of services provided by these entities.
- Works closely with the interdisciplinary team and providers to ensure appropriate referrals, follow-up and optimal patient outcomes over time. Is able to close the loop on referrals and any pending patient care needs efficiently.
- Exhibits behaviors and actions which create a high level of patient satisfaction, contributes to positive patient relations and reflects respect for a patient’s rights, needs and confidentiality.
- Participates and can lead pertinent groups (such as interdisciplinary teams).
- Tracks, analyzes and interprets patient satisfaction, outcome measure and individual patient treatment plans.
Requirements:
Education:
- Registered Nurse, BSN in Nursing, preferred.
Experience:
- Minimum of two years of experience in a health care setting and related experience with quality, care coordination and population health preferred.
- Considerable knowledge of health care facilities, policies and issues, and of the full spectrum of community patient care services
- Considerable knowledge of health care and social management principles
- Ability to coordinate various functions and activities for maximum cooperation and integration of services providers and persons receiving care within a clinic for continuum of care services
- Ability to direct, instruct and advise staff, and to receive and effectively react to day-to-day problems
- Ability to utilize strong communication skills, both written and oral, and effectively demonstrate an interactive style of care coordination
- Ability to understand and implement sensitivity and culture of care measures appropriate to a diverse population
- Ability to work with various levels of the CHRISTUS organization including clinical, financial, administrative and medical staff.
Certifications, Registrations, or Licenses:
- Current New Mexico Nursing License
Work Schedule:
MULTIPLE SHIFTS AVAILABLE
Work Type:
Per Diem As Needed
RN Liaison - Sub Acute Rehab Facilities
Eddy Visiting Nurse and Rehab Association has a rewarding opportunity for a fulltime position to be a part of EVNRA team as a liaison in our subacute rehab facilities!
This candidate would assist with homecare referrals and discharge planning and work closely with the community providers to obtain necessary documents. This position would participate in rounds and status of patients who are preparing to return home. Attention to detail, strong communication skills, and organization a must, along with an understanding of homecare regulations.
If you want to make a difference in a patient’s life, give us a try!
Requirements:
- NYS Registered Nurse license
- 1 year of RN experience
- Valid NYS driver's license
Key skills required:
- Strong interpersonal skills
- Excellent computer skills
- Ability to multitask multiple patient referrals
- Organization
- Team player
- Strong time management and clinical skills
- Experience working with seniors and/or in HomeCare preferred
- Experience in discharge planning and case managing a plus!
Eddy VNRA provides a comprehensive orientation and supportive work environment. Apply today for more information!
Pay Range: $38.00 - $50.18
Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
