RN Care Coordinator

About the role

Southwest Care Center (SCC) is a non-profit healthcare organization serving the underserved community since 1996. We provide medical, behavioral healthcare, and community outreach services at multiple locations in Santa Fe, Albuquerque, Farmington, and Roswell, NM. As an FQHC-LAL, SCC is currently seeking a Registered Nurse Care Coordinator.

Responsibilities

• Identify and follow up on hospital and emergency department admissions and discharges.
• Oversee care transitions (hospital to home, hospital to rehabilitation center/nursing facility) and coordinate follow-up with patients.
• Initiate patients' medication reconciliation.
• Oversee patients' linkages to community resources and social support.
• Closely coordinate and facilitate patients' care with primary care providers, behavioral health specialists, and outside providers.
• Acts as a patient advocate, protecting privacy and confidentiality.
• Maintain a comprehensive working knowledge of community resources, payer requirements, and network services for the target population.
• Promote patients' independence by establishing care goals, teaching, and counseling patients, friends, and family, and reinforcing their understanding of disease, medications, and self-care skills.
• Maintains a cooperative relationship among healthcare teams by communicating information, responding to requests, building rapport, and participating in team problem-solving methods.
• Models and supports the development of Medical Assistants.
• Demonstrates prioritization, critical thinking, and decision-making skills.
• Offers insight and direction in dealing with clinical situations and responds accordingly.
• Embraces change that improves results and assists others through the change process.
• Acts as a team member, providing efficient patient care practices, collaborating with the healthcare team to assure a team approach.
• Conducts nurse visits to ensure the patient care plan is followed.
• Communicates effectively in a timely manner, maintaining good working relationships with the healthcare team in solving problems/issues in service delivery.
• Provides constructive feedback, resolves conflicts and issues in a timely manner, and refers issues as appropriate.
• Maintains effective lines of communication with staff.
• Communicates significant clinical issues, keeping leadership apprised of workflow issues and supervisory activities.
• Contributes to developing and attaining long-range objectives, including but not limited to: financial goals, operations improvement, quality improvement, resource utilization, and clinical practice enhancements.
• Represents the clinic on interdisciplinary committees/work groups.
• Identifies key performance indicators for self and team members and develops methods for reaching established goals and measuring each.
• Participates in developmental and educational programs.

Qualifications

• Bachelor's degree in Nursing (BSN).
• Current RN license in the state of New Mexico.
• Experience in a healthcare setting preferred.
• Strong interpersonal and communication skills.
• Ability to work independently and as part of a team.
• Knowledge of community resources and payer requirements.

Benefits

• Full benefits package including medical, dental, vision, life, long-term, and short-term disability.
• 401(k) retirement fund.
• CME reimbursement available.

Pay

Competitive salary based on experience.

Schedule

Regular scheduled weekly hours of 40.