Care Coordinator (RN) - Medicine - Days

About the role

This position functions as a part of a multidisciplinary team, including physicians, social workers, discharge planning assistants and payers. Ensures patient’s progress in the acute episode of care through post-discharge is quality-driven, efficient, and safe. Also, patient-focused and outcome-oriented.

Responsibilities

• Works with the attending and consulting physicians to facilitate effective and efficient transition through the process of hospitalization.
• Collaborates with all members of the multi-disciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum, as well as appropriately reimbursed by payers as contracted, and that resources are efficiently and effectively utilized.
• Solves psychosocial patient care issues and develops complex patient transition/discharge plans as needed, interacting with patients, family members, healthcare professionals, community and state agencies.
• Serves as an advanced clinical resource to the team, serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information.
• Maintains hospital compliance with the Quality Improvement Organization (QIO) series and CMS guidelines, utilizes medical necessity criteria as a tool to assess appropriateness of level and setting of care, assists in the denial and appeals process, assesses quality and identifies and reports potential risk management issues.
• Participates in and completes all patient safety initiatives appropriate to the position.
• Conducts all job responsibilities according to VCUHS' Mission and Values.
• Establishes and maintains a professional rapport with providers, patients/families, and internal customers.

Requirements

• Licensure, Certification, Or Registration Requirements For Hire: Licensed Registered Nurse in the State of Virginia or eligible; Licensure, Certification, Or Registration Requirements For Continued Employment: Current RN licensure in Virginia.
• Complete 15 Continuing Education Units per year.
• Experience: Minimum of three (3) years of nursing experience in an acute care setting; Experience PREFERRED: Academic healthcare experience, one (1) year of UM/Care Coordination experience, clinical experience with specialty patient population.
• Education/training: REQUIRED: Baccalaureate Degree in Nursing from an accredited School of Nursing, or a Bachelor’s degree in a biological, health or social sciences field from an accredited school; Education/training PREFERRED: Master's Degree in Nursing or a healthcare related field from an accredited program.