RN-Care Coordinator

UnityPoint Health; Dubuque (IA); On-site; USD 30,000 - 47,000; Full time

Benefits offered by this job

Paid time off

401K matching

Dental insurance

Health insurance

Job summary

UnityPoint Health in Dubuque, IA is seeking a Care Coordinator to integrate and coordinate the clinical care of individuals across the care continuum. The role focuses on promoting continuity of care, coordinating interdisciplinary plans, and educating patients and families to empower informed decisions.

The ideal candidate will partner with care teams, leverage resources, and advocate for patients and payers to ensure safe, timely transitions between hospital, outpatient, and community services.

Qualifications

• The role requires coordinating care across inpatient and outpatient settings.
• Ability to educate patients and families about care options.
• Facilitates interdisciplinary plans of care with care teams.

Responsibilities

• Screens and assesses patients to identify needs and referrals to multi-disciplinary services.
• Prioritizes patients for care coordination based on defined criteria.
• Coordinates interdisciplinary plan of care and ensures safe transitions across care settings.
• Partners with Social Work and Utilization Management for discharge planning and continued stay reviews.
• Educates patients and families on care options and resources.

Skills

Care coordination

Communication

Education & patient teaching

Resource utilization

Team collaboration

Job description

Overview

Shift: Full-time; Days, 7:30 am - 4:00 pm, for 32 hours per pay period.

The Care Coordinator integrates and coordinates the clinical care of individuals. Facilitates the interdisciplinary plan of care to meet multiple service needs, promotes continuity through elimination of fragmentation of care/service and facilitates the effective utilization of resources. Serves as educator and a central source of communication for the individual and their support systems.

Why UnityPoint Health?

At UnityPoint Health, you matter. We're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you're in. Here are just a few:

• Expect paid time off, parental leave, 401K matching and an employee recognition program.
• Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.
• Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family.
• With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.
• And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.

Find a fulfilling career and make a difference with UnityPoint Health.

Responsibilities

Care Coordination

• Screens 100% of adult Medical/Surgical in-patient and observation patients and assesses the individual's health status including clinical conditions, support systems and resources to identify needs and make referrals to appropriate multi-disciplinary services.
• Prioritizes patients for care coordination based on defined criteria.
• Monitors and coordinates an interdisciplinary plan of care in partnership with the individual and their support services for needs and services across the health care continuum and for transition through the levels and locations of care.
• Partners with the Social Work team for the development and implementation of an effective discharge plan for complex care patients. Works with internal and external resources to co-ordinate a timely safe transition of patient to the appropriate level of care.
• Participates with the interdisciplinary team in daily rounds, planning delivery and evaluation of patient-focused care for prioritized patients.
• Documents the case management plan to include clinical needs, barriers to quality care, effective utilization of resources and pursues denials of payment and referrals in a timely, legible manner.
• Integrates with ambulatory care management team, especially with high risk, chronically ill patients.
• Collaborates with patients, caregivers, internal/external healthcare providers, agencies and payers to assist in planning and executing a safe discharge.
• Collaborate with Utilization Management team on continued stay review.
• Educates patients and families regarding available options for care through the continuum.
• Advocates for both the patient and the payer to facilitate positive outcomes for the patient, healthcare team and the payer. If a conflict arises, the needs of the client must be the priority.
• Focuses on the transition of care that includes transfers to and from the hospital to the next level of care setting that is safe, effective, timely and complete. This includes ensuring there are referrals, appointments and information handed off to community services and providers. This may include transitions of care into the hospital, during the hospital stay, during the post-acute care and into the community.
• Education
• Provides and oversees the education of the patient and family as needed to develop a plan of care.
• Educates patients and families regarding available options for care through the continuum.
• Communicates patient/family learning needs that surface to the direct care nurse. Collaborates with direct care nurse on education plan.
• Refers to content experts as appropriate - i.e. wound care team, Diabetic Educators, Respiratory Therapy or PT.
• Facilitates and documents education related to medication adherence.
• Facilitates and documents patient self-management education.
• Utilization Management/Revenue Cycle
• Applies the utilization management (UM) plan by functioning in the UM role as assigned.
• Knowledgeable of utilization criteria used by payers when communicating with the healthcare team and patient. This includes observation, inpatient, and outpatient criteria.
• Demonstrates a working knowledge of financial and reimbursement processes to facilitate medical cost management, including best practices, effective utilization of resources, linking clinical and financial aspects of care, and ac