Job Summary:
The Care Coordinator is responsible for managing and coordinating care and services for assigned patients throughout an episode of illness or treatment. This role involves collaboration with patients, families, physicians, care teams, and payors to ensure effective, efficient, and cost-conscious care delivery. The Care Coordinator applies advanced clinical skills to assess, plan, intervene, and evaluate patient care, promotes optimal resource utilization, and advocates for patients throughout their care journey, including discharge or transfer processes.
Responsibilities:
- Coordinate patient care and services in collaboration with patients, families, physicians, and interdisciplinary teams.
- Utilize advanced clinical nursing skills to assess, plan, intervene, and evaluate patient care.
- Promote and evaluate effective utilization of healthcare resources and community services.
- Assume a leadership role within the patient care team to achieve optimal clinical and resource outcomes.
- Evaluate and analyze quality and utilization cases, including admission/discharge criteria, observation stays, readmissions, Medicare, and diagnosis-related criteria.
- Participate in ongoing outlier reviews.
- Serve as a resource to facilitate communication among providers and monitor services rendered.
- Maintain patient and family availability as a resource throughout the care episode.
- Initiate appropriate clinical pathways based on admission diagnoses.
- May be assigned to the Emergency Department to coordinate care for emergency episodes.
- Advocate for patients and families until discharge or appropriate transfer to another level of care.
Required Skills & Certifications:
- Current Registered Nurse license in California.
- At least one year of recent case management experience in an acute care setting.
- Current CPR certification.
- Strong clinical assessment and care coordination skills.
- Ability to collaborate effectively with interdisciplinary teams and payors.
- Knowledge of utilization management and clinical pathways.
Preferred Skills & Certifications:
- Experience working in emergency department settings.
- Familiarity with Medicare and diagnosis-related group criteria.
- Leadership skills in clinical and resource management.
Special Considerations:
- May require availability for emergency department assignments.
- Role involves coordination across multiple care settings and payors.
- Must maintain strong communication and advocacy for patients and families throughout care episodes.
Scheduling:
- Work schedule and shift assignments may vary based on patient care needs and departmental requirements.
- Shifts may include standard business hours with potential for flexibility depending on caseload and emergency department assignments.