RN - Hospital Care Coordinator

Principle Responsibilities

• Supports the progression of care for complex patients.
• Completes clinical assessments and participates in patient care rounds to ensure critical interventions and procedures are completed to achieve optimal patient outcomes.
• Ensures timely progression of care with proactive identification and elimination of potential delays/barriers in patient care.
• Escalates barriers to leaderships for resolution.
• Collaborates with healthcare team, community care providers, patients and families to ensure effective clinical and timely transition of care.
• Provides information and supports activities related to palliative care and advanced care planning to patients and families experiencing chronic disease progression.
• Coordinates appropriate clinical transition of patients in the hospital and Emergency Department.
• Collaborates with interdisciplinary team to plan anticipated transfer or discharge.
• Serves as subject matter expert with high knowledge base of integrated, seamless post-discharge care and services offered by the system.
• Affirms clinical stability for discharge and oversees clinical details of transitions.
• Ensures accurate and complete discharge orders.
• Identifies patients and families with complex discharge issues, rehab services for functional issues to prepare patients for internal or external transitions.
• Conducts screening or assessment tests to select patients and communicates the need for follow-up with community resources in collaboration with provider.
• Participates in care system process that prevent potentially preventable readmissions.
• Plans and participates in transition conferences with patients and families.
• Utilizes tools and technology to identify and intervene with patients who are at risk for readmission.
• Ensures a complete clinical handoff occurs for at-risk patient, which may include referrals.
• Collaborates with health care team to promote appropriate length of stay.
• Utilizes tools and technology to support appropriate length of stay management.
• Facilitates timely referrals and transfers of information.
• Safeguards outpatient complex clinical care services are in place at the time of discharge along with other complex clinical care needs.
• Demonstrates appropriate clinical resource management and adherence to commercial and regulatory requirements.
• Supports level of care activities including use of established inpatient guidelines and internal and external utilization criteria.
• Collaborates with Social Workers to identify trends or concerns related to reimbursement and discharge planning.
• Sets up interventions for patients who are admitted under observation status.
• Provides information and assistance for identified financial or social needs.
• Maintains knowledge of government and private payer networks and services.
• Collaborates with community and health care resources based on need to coordinate care for the patient.

Required Qualifications

• Bachelor's degree in nursing
• 2 to 5 years of nursing experience, with having practiced the equivalent of 2 years in an acute care setting
• Licensed Registered Nurse - MN Board of Nursing required
• Licensed Registered Nurse - WI Dept of Safety & Professional Services required
• Case/Care Management Certification within 2 years of hire required, except for Mother/Baby units where an Obstetric/Fetal related certification is acceptable in place of a Case/Care Management Certification.

Physical Demands

• Light Work: Lifting weight up to 20 lbs. occasionally, up to 10 lbs. frequently
• Casual role: 8-hour day shifts
• Occasional weekends

Pay Range

Pay Range: $44.64 to $61.76 per hour

Shift, weekend and/or other differentials

Your starting rate would depend on a variety of factors including, but not limited to, your experience, education, and the union agreement (if applicable).

Benefits Summary

Allina Health believes the best way to provide safe and compassionate care for our patients is by nurturing the passion of those who care for them. That’s why we devote extraordinary resources to help you grow and thrive — not only as a professional but also as a whole person. When you join our team, you have access to a wealth of valuable employee benefits that support the total well-being — mind, body, spirit and community — of you and your family members. Allina Health is all in on your well-being. Because well-being means something different to everyone, our award-winning program provides you with the resources you need to help you navigate your personal journey. This includes well-being dollars, dedicated well-being navigators, and many programs, activities, articles, videos, personal coaching and tools to support you on your journey. In addition, Allina Health offers employee resources groups (ERGs) -- voluntary, employee-led groups that serve as a resource for members and organizations by fostering a diverse, inclusive workplace aligned with the organization's mission, values, goals, business practices, and objectives. Allina Health also engages employees in various community involvement and volunteering events.

Benefits

• Medical/Dental
• PTO/Time Away
• Retirement Savings Plans
• Life Insurance
• Short-term/Long-term Disability
• Voluntary Benefits (vision, legal, critical illness)
• Tuition Reimbursement or Continuing Medical Education as applicable
• Student Loan Support
• Benefits to navigate the Federal Public Service Loan Forgiveness Program