Onsite Care Coordination Nurse

Jobtailor; Louisville (KY); On-site; USD 75,000 - 95,000; Full time

Job summary

Jobtailor is seeking a qualified registered nurse to support discharge planning and care coordination within Louisville area facilities. You will assess patients at admission, coordinate with care teams, and educate patients and families throughout the discharge process.

Ideal candidates have acute care experience, knowledge of health plan processes, and comfortable using EMRs and MS Office. This role emphasizes patient education, safety, and collaboration to reduce readmissions.

Qualifications

• Current, unrestricted Registered Nurse (RN) license in Kentucky.
• Must live within 30–60 minutes of Norton Audubon Hospital, Louisville, KY.
• Minimum of 3 years acute care nursing experience.
• Experience with discharge planning or care coordination in hospital or health plan setting.
• Experience with Microsoft Office applications and electronic medical records.
• Valid driver’s license and personal vehicle liability insurance.
• TB screening and ACHA Level II background clearance, including fingerprinting.
• Private workspace for remote documentation; reliable home internet.
• BSN preferred; experience in care management, coaching, or utilization management a plus.
• Bilingual English/Spanish preferred; knowledge of HEDIS/Stars measures a bonus.

Responsibilities

• Conduct comprehensive face-to-face assessments of newly admitted members at assigned acute care facilities.
• Evaluate physical, psychosocial, and health needs; refer members to Humana programs as appropriate.
• Support and educate members and families on discharge planning from admission through post-discharge.
• Facilitate follow-up visits with primary care providers.
• Identify gaps in care, safety concerns, and barriers to discharge.
• Develop and implement strategies to address care and discharge issues.
• Collaborate with attending providers, facility case managers, and other healthcare professionals.
• Provide education on diagnoses, medications, and preventive measures.
• Complete required documentation accurately and promptly.
• Maintain infection control, safety, and patient privacy standards.
• Coordinate care to improve health outcomes and reduce unnecessary readmissions.

Skills

Discharge Planning

Care Coordination

Patient Education

Collaboration

Communication

Problem-Solving

Empathy

Education

Education

Bachelor’s degree in Nursing (BSN)

Certification in Care Management

Tools

Electronic Medical Records

Microsoft Word

Microsoft Outlook

Microsoft Excel

Job description

• Conduct comprehensive face-to-face assessments of newly admitted members at assigned acute care facilities
• Evaluate physical, psychosocial, and health needs and refer members to Humana programs as appropriate
• Support and educate members and families on discharge planning from admission through post-discharge
• Facilitate follow-up visits with primary care providers
• Identify gaps in care, safety concerns, and barriers to discharge
• Develop and implement strategies to address care and discharge issues
• Collaborate with attending providers, facility case managers, and other healthcare professionals
• Provide education on diagnoses, medications, and preventive measures
• Complete required documentation accurately and promptly
• Maintain infection control, safety, and patient privacy standards
• Coordinate care to improve health outcomes and reduce unnecessary readmissions

Requirements

• Current, unrestricted Registered Nurse (RN) license in the state of Kentucky
• Must live within a 30–60 minute driving distance of Norton Audubon Hospital, Louisville, KY
• Minimum of 3 years recent acute care nursing experience
• Experience with discharge planning or care coordination in a hospital or health plan setting
• Experience with Microsoft Office applications (Word, Outlook, Excel) and electronic medical records
• Valid driver’s license, dependable automobile, and proof of personal vehicle liability insurance
• Participation in Tuberculosis (TB) screening and ACHA Level II background clearance, including fingerprinting
• Other credentialing and screening as required by the assigned facility
• Private workspace for remote documentation
• Minimum home internet speed of 25 Mbps download and 10 Mbps upload
• Preferred: Bachelor’s degree in Nursing (BSN)
• Preferred: Experience in care management, health promotion, or coaching
• Preferred: Previous Utilization Management experience
• Preferred: Previous health plan experience
• Preferred: Bilingual English/Spanish
• Preferred: Certification in Care Management or related specialty
• Preferred: Knowledge of HEDIS and Stars measures

Core Competencies

Demonstrates expertise in acute care nursing, discharge planning, and care coordination, with a strong focus on patient education and collaboration with healthcare professionals. Proficient in maintaining safety standards and utilizing electronic medical records for effective documentation.

Highest-signal resume keywords

• Registered Nurse (RN) License
• Acute Care Nursing Experience
• Discharge Planning
• Care Coordination
• Microsoft Office Applications

Hard Skills

• Acute Care Nursing
• Discharge Planning
• Care Coordination
• Patient Education
• Documentation
• Infection Control
• Health Needs Assessment
• Safety Standards
• Care Management
• HEDIS and Stars Measures

Soft Skills

• Collaboration
• Communication
• Problem-Solving
• Empathy
• Education

Certifications & Qualifications

• Registered Nurse (RN) License
• Certification in Care Management

Industry Keywords

• Acute Care Facilities
• Health Promotion
• Utilization Management
• Patient Privacy Standards
• Bilingual English/Spanish

Tools & Technologies

• Electronic Medical Records
• Microsoft Word
• Microsoft Outlook
• Microsoft Excel