Care Coordinator RN

CommonSpirit Health; Sacramento (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Dignity Health - Methodist Hospital in Sacramento, CA seeks an experienced RN Care Coordinator to guide patients and families through the healthcare continuum and coordinate individualized care plans for optimal health outcomes.

You will collaborate with interdisciplinary teams to assess needs, coordinate services, and develop comprehensive plans, advocating for patients, facilitating transitions, and linking to community resources. Strong clinical judgment and communication are essential.

Qualifications

• RN license in California required.
• 2+ years acute hospital experience or Master’s in Case Management/Nursing in lieu of 1 year experience.
• BLS certification within 3 months of hire.
• Knowledge of CMS standards and requirements.
• Strong communication and collaboration skills.
• Ability to coordinate care across settings as part of a team.

Responsibilities

• Completes discharge planning assessment and updates plan as needed.
• Facilitates multidisciplinary discharge planning with care team and post-acute providers.
• Collaborates with healthcare team and post-acute services for timely transitions.
• Identifies readmission risk and implements 30-day interventions.
• Educates and advocates for patients throughout care continuum.

Skills

Care coordination

Discharge planning

Multidisciplinary collaboration

Communication

Time management

Advocacy

Education

RN (Registered Nurse) licensure

BSN preferred

Tools

Electronic Health Records (EHR)

CMS guidelines

Job description

Job Summary and Responsibilities

As our RN Care Coordinator, you will help patients and their families navigate the healthcare continuum and coordinate individualized care plans so they can achieve optimal health outcomes and experience a seamless transition across care settings.

Every day, you will collaborate with interdisciplinary teams to assess patient needs, coordinate services, and develop comprehensive care plans. You will be expected to advocate for patients, facilitate transitions of care, monitor progress toward goals, and connect patients with appropriate community and healthcare resources.

To be successful in this role, you will demonstrate strong clinical judgment, exceptional communication and collaboration skills, and experience coordinating care across multiple disciplines and settings while maintaining a patient-centered approach.

• Completes and documents a discharge planning assessment on those patients identified by the designated screening process, or upon request, and reassesses the patient as appropriate while updating the plan accordingly.
• Facilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members, the patient and/or patient representative, and post-acute care providers in accordance with the patient's clinical or psychosocial needs, choices, and available resources.
• Collaborates with the healthcare team and post-acute service providers to ensure timely and smooth transitions to the most appropriate type and setting of post-acute services based upon patients' clinical needs.
• Identifies risk for readmission and implements interventions to mitigate those risks for at least a 30-day period.
• Responsible for patient education and advocacy.

Job Requirements

Required:

• Graduate of an accredited school of nursing
• Minimum of two (2) years of acute hospital clinical experience or a Master's degree in Case Management or Nursing field in lieu of 1 year of experience
• Active Registered Nurse (RN) license in the State of California
• Basic Life Support (BLS) certification (American Heart Association) required within 3 months of hiring
• Knowledge, Skills, Abilities, and Training:
• Knowledge of CMS standards and requirements.
• Able to apply clinical guidelines to ensure progression of care.
• Knowledge of managed care and payer environment preferred.
• Must have critical thinking and problem-solving skills.
• Collaborate effectively with multiple stakeholders.
• Professional communication skills.
• Understand how utilization management and case management programs integrate.
• Ability to work as a team player and assist other members of the team where needed.
• Thrive in a fast paced, self-directed environment.
• Proficient in prioritizing work and delegating where indicated.
• Highly organized with excellent time management skills

Preferred:

• Bachelor's Degree in Nursing (BSN) or related healthcare field
• At least five (5) years of nursing experience
• Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM Certification

Where You’ll Work

Founded in 1973, Dignity Health - Methodist Hospital is a 158-bed, acute care, nonprofit hospital located in Sacramento, California. Serving over 80,000 patients annually, the hospital offers a full complement of services including a Level II NICU, heart care, cancer care, women’s health, and neurology. Additionally, Methodist Hospital of Sacramento has been recognized as an LGBTQ+ Healthcare Equality Leader by the Human Rights Campaign Foundation and is a Joint Commission-certified Primary Stroke Center.

One Community. One Mission. One California