Care Coordination RN: Discharge & Transition Navigator

Wellstar Health System; Marietta (GA); On-site; USD 65,000 - 85,000; Full time

Job summary

The Care Coordinator RN (CC RN) at Wellstar Health System 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.

The role integrates care facilitation, care progression and transitional care planning functions, collaborating with physicians and the care team to

Qualifications

• 1 year nursing experience in acute care required.
• Excellent written and verbal communication.
• Ability to work under stress in a fast-paced environment.
• Knowledge of local, state and federal regulations.
• Strong assessment, interview and problem-solving skills.
• Ability to collaborate with physicians and care team for discharge progression.

Responsibilities

• Initiate assessment of chronic disease and psychosocial needs at discharge.
• Coordinate with PAS, financial counselor, UM nurse on insurance requirements.
• Collaborate with patient, families and physicians to support care progression and discharge plans.
• Meet with physicians and care team to optimize patient management.
• Manage all aspects of discharge planning and post-acute referrals.
• Document encounters and ensure up-to-date medical records.
• Identify barriers to discharge and escalate as needed.
• Participate in Interdisciplinary Rounds to align discharge date.

Skills

Communication skills

Maturity

Self-direction

Stress management

Organization

Problem-solving

Regulatory knowledge

Collaboration

Education

Associates/Bachelor's in Nursing

Job description

The Care Coordinator RN (CC RN) at Wellstar Health System 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.

The role integrates care facilitation, care progression and transitional care planning functions, collaborating with physicians and the care team to