Registered Nurse Care Coordinator Primary Care

Children's Hospital of Philadelphia; Philadelphia (Philadelphia County); On-site; USD 65,000 - 80,000; Full time

Job summary

Children's Hospital of Philadelphia seeks a Regional Nurse Care Coordinator to provide care coordination for Medicaid patients with chronic conditions. The role involves developing care plans, liaising with families, and improving care delivery across settings. Ideal candidates will have a Technical Diploma in Nursing and at least three years of nursing experience, preferably in pediatric care. This position emphasizes collaboration and communication to enhance patient outcomes.

Qualifications

• Requires 3 years of RN experience, preferably in Pediatric outpatient.
• Experience in Care or Case management is preferred.

Responsibilities

• Identify patient and family needs across multiple domains.
• Develop care plans in collaboration with families.
• Facilitate care transitions across various settings.

Skills

Computer Competency

Information Literacy

Coordination of patient care

Education

Technical Diploma Nursing

Bachelor's Degree Nursing

Tools

EPIC

Job description

SHIFT:

Day (United States of America)

Seeking Breakthrough Makers

Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.

CHOP’s Commitment to Diversity, Equity, and Inclusion

CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children. We strongly encourage candidates of all races, colors, ethnicities, religions, perspectives, sexes, backgrounds, and lived experiences to apply.

A Brief Overview

This RN Care Coordinator position requires 3 years of previous RN work expereince. The position will cover Medicaid patients across the Primary Care Network- except New Jersey. This is a newer position and the RN will be working to build their panel of patients. The patients will have at least 2 chronic conditions, which could include Autism, ADHD, Asthma etc. The Nurse will act as the liaison between the Primary Care office and families which will include care management, telephone support and communication with the families. Will include creating care plans for the families with goals, letters of medical necessity. Previous Care or Case management, Peds and Primary Care expereince are preferred. Will also consider those with expereince in Care or Case management with insurance companies as well.

The Regional Nurse Care Coordinator provides care coordination to patients with emergency room and/or hospitalizations across the spectrum from the inpatient to the outpatient setting. Besides the Children's Hospital of Philadelphia, institutions will include all regional hospitals in our service area. S/he will also work closely with the entire primary care team to improve the quality of care delivery, to promote seamless transitions between the inpatient to the outpatient setting, and to optimize communication among care providers. By working directly with families and all care providers, s/he will support the primary care practices in the care coordination functions consistent with Medical Home Concepts to prevent unnecessary emergency room visits, prevent admissions and re-admissions and to promote the ultimate patient and family experience at CHOP. The Regional Nurse Care Coordinator will specifically work with CHOP primary care practices to delivery coordinated care for a subset of patients who are determined to be at highest risk for urgent care and emergency room visits or hospitalizations. This role may work with any patient/family identified as needing care coordination services, or may work with a disease-specific population.

What you will do

• Care Coordination:
• Identify patient and family needs across medical, behavioral, psychosocial, and educational domains
• Develop a care plan in collaboration with the family
• Teach/Coach the patient and family the skills needed to manage their needs and acquire increased independence/self-management
• Support adherence to plan of care and assess accomplishment of goals set in the care plan
• Facilitate all care transitions across primary care, inpatient, specialists and community settings
• Identification and Utilization of Resources
• Contact agencies, supply companies, insurance providers and all medically related providers
• Work closely with outside agencies to maximize the best possible scenario for a medically complex pt.
• Documentation
• Provide clear and concise nursing documentation and utilize all EPIC tools available
• Provides LOMN, POC, Prior auth, and all forms needed to provide the best available care.
• Analysis and Planning
• Reviews emergency and acute admission discharge summaries for patterns of care that can be impacted by better care planning and coordination
• Using various data sources, identifies candidate patients for care coordination
• Leadership
• Work to promote stronger partnerships across the CHOP Care Teams

Education Qualifications

• Technical Diploma Nursing Required
• Bachelor's Degree Nursing Preferred

Experience Qualifications

• At least three (3) years nursing experience. Required
• Pediatric outpatient experience Preferred

Skills and Abilities

• Computer Competency
• Navigation and basic search functions of the Internet using Internet Explorer
• Use of Outlook 2007 email, opening of attachments, attaching new files to emails and saving attached files to computer
• Basic use of computers, printers, monitors, patient care devices, and Fax machines
• Information Literacy
• Use of Internet and Intranet to look up basic electronic resources for practice
• Ability to find and print Patient Family Education Documents
• Information Management Literacy
• Navigation of electronic health information records and ability to review specific patient data in a clinical information system
• Understanding of policies and procedures around timeliness of care, use of a clinical information system and support of safe nursing practice
• Ability to discuss data presented in charts and tables
• Discuss the responsibilities of each user of an electronic record related to confidentiality and privacy
• Coordination of patient care information in a fragmented environment where there is partially online and partially paper references

Licenses and Certifications

• Registered Nurse (Pennsylvania) - Pennsylvania State Licensing Board - upon hire - Required and
• Basic Life Support (BLS) - issued through on organization that requires a hands-on instructor lead psychomotor skills verification (ex. American Heart Association or Red Cross). - upon hire - Required

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, professionals working onsite—at any CHOP location, for any portion of time—must be vaccinated for COVID-19. Learn more.

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