Patient Care Coordinator RN - Part-Time

Mercy Cedar Rapids; Baltimore (MD); On-site; USD 28,000 - 41,000; Part time

Job summary

Mercy Cedar Rapids is seeking a Patient Care Coordinator to support patient-centered care, acting as an advocate for patients and families. This role focuses on complex disease management, discharge planning, and clinically based care coordination in inpatient and outpatient settings.

Responsibilities include reviewing complex patient status, coordinating with physicians and care teams, applying InterQual criteria, and ensuring timely, quality care while adhering to safety guidelines and

Qualifications

• BSN or higher degree required or equivalent experience.
• Current Iowa RN license to practice nursing.
• Familiarity with utilization management and discharge planning.

Responsibilities

• Review complex patient status and plan of care.
• Coordinate with physicians and care teams across units.
• Apply InterQual criteria for continued stay reviews.
• Ensure timely and quality care delivery and communication with payors.

Skills

Clear communication

Self-starter

InterQual criteria

Care coordination

Education

BSN or higher

Current Iowa RN license

Tools

InterQual Criteria

Job description

Work Shift

Day

Scheduled Weekly Hours

24

Summary

This position supports Mercy’s philosophy of patient centered care acting as an advocate to patients and their families. The Patient Care Coordinator works specifically with patients experiencing complex disease processes needing multiple sources of health care support. The Patient Care Coordinator provides clinically based holistic care coordination and discharge planning in the inpatient and outpatient setting.

Job Description

Job Duties

• Complex care review of patient status
• Develops an understanding of referral sources for assigned caseload
• Collaborates with other programs and departments
• Assists in the teaching needs for patient and families as needed
• Ability to work with a variety of personalities, character or ability
• Serves as a liaison between physicians and departments to ensure timely and quality care delivery
• Conducts peer to peer reviews with third party payors when necessary to ensure reimbursement.
• Follows Mercy’s safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

Department Specific Duties

Care Coordination

• Communicates daily with physicians and clinical staff regarding the plan of care and progress towards goals
• Co-facilitates care conferences on assigned unit
• Ensures appropriate admission status has been documented applying InterQual Criteria and communicates effectively with physicians per Utilization Review process.
• Applies InterQual criteria for continued stay review to effectively manage length of stay and communicate effectively with commercial insurance reviewers.
• Provides clinical data/information to contracted third party payers while patient is hospitalized to ensure continued reimbursement and to avoid reimbursement delays.
• Completes case management assessment of patients and support systems in order to facilitate the most appropriate and timely transition plan.
• Seeks patients eligible for admission to the Transitional Care Unit and other appropriate referral organizations.

Knowledge, Skills and Abilities

• Sound background in complex nursing principles and procedures and demonstrated ability to provide safe and effective nursing care.
• Ability to communicate well orally and in writing; via phone, email and face to face; establish rapport with clients/patients.
• Self-starter; able to initiate and direct own activities in an organized manner and make decisions within the framework of the responsibility and authority of the job.
• Knowledge of utilization management process, discharge planning and managed care processes is a plus.

Professional Experience

• Previousnursing experience required;case management experience preferred.
• Working knowledge of healthcare insurance, Medicare and Medicaid is preferred.

Education

• A baccalaureate degree in nursing, current certification in patient populationor relevant experience in lieu of a degree required.

Licensure, Certification, Registration

• Basic Life Support (BLS)in accordance with the American Heart Association required.
• Current RN license to practice as a Registered Nurse inthe state of Iowarequired.
• Iowa Dependent Adult Abuse/Iowa Child Abuse Mandatory Reporter training required. Employee must submit certification of completed training to Human Resources prior to start or transfer date.

Physical Requirements

Light: Exert up to 20 lbs. of force occasionally and/or up to 10 lbs. of force frequently

Pay Rate Type

Hourly

_ Mercy is an independent, community-based organization supporting the Cedar Rapids area for over 120 years. _

Mercy is an equal-opportunity employer. We value diversity, equity, and inclusion and therefore evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status, and other legally protected characteristics.