RN Care Coordinator - Care Coordination - Days

Virginia Commonwealth University Health Systems; Richmond (VA); On-site; USD 73,000 - 121,000; Full time

Job summary

Tappahannock Hospital is seeking an experienced RN to lead patient transitions from hospital to home or to next care settings. You will work with the care team to assess needs, coordinate services, and ensure timely, safe discharges.

The role emphasizes collaboration with physicians, social workers, and community agencies, while maintaining compliance with regulatory guidelines and protecting patient safety.

Qualifications

• Licensed Registered Nurse in Virginia or eligible.
• Current VA RN licensure; 15 Continuing Education Units per year.
• Minimum 3 years of nursing experience in an acute care setting.
• BSN from an accredited school or a Bachelor's in a biological/health/science field.
• Master's Degree in Nursing or healthcare-related field preferred.

Responsibilities

• Collaborate with attending and consulting physicians to facilitate transitions through hospitalization.
• Coordinate with multidisciplinary team to meet patient needs and ensure coordinated care across continuum.
• Consult social workers to resolve psychosocial issues and develop complex discharge plans.
• Liaise between hospital and community agencies for referrals and information exchange.
• Ensure compliance with CMS/QIO guidelines and risk management requirements.

Skills

Nursing

Care Coordination

Discharge Planning

Interdisciplinary Collaboration

Education

BSN

Biological/Health Sci bachelor's

MSN (preferred)

Job description

Tappahannock Hospital

Monday to Friday 8-4:30 pm. Occasional weekends

Daily work expectations:

• 1.Initial assessment on patient upon admission in Acute Care and ICU. Will cover ER if needed.
• 2.Assess patient needs and collaborate with interdisciplinary team on meeting their needs
• 3.Discharge plan for patient
• 4.Provide patient with resources when needed such as durable medical equipment
• 5.Deliver Important message from Medicare and MOON letters
• 6.Coordinate with post-acute services and community services board as needed

Licensure, Certification, or Registration Requirements for Hire:

Licensed Registered Nurse in the State of Virginia or eligible

Licensure, Certification, or Registration Requirements for continued employment:

Current RN licensure in Virginia Complete 15 Continuing Education Units per year

Experience REQUIRED:

Minimum of three (3) years of nursing experience in an acute care setting

Experience PREFERRED:

Academic healthcare experience One (1) year of UM/Care Coordination experience Clinical experience with specialty patient population

Education/training REQUIRED:

Baccalaureate Degree in Nursing from an accredited School of Nursing,or a Bachelor's degree in a biological, health or social sciences field from an accredited school.

Education/training PREFERRED:

Master's Degree in Nursing or a healthcare related field from an accredited program

Independent action(s) required:

• Works with the attending and consulting physicians to facilitate effective and efficient transition through the process of hospitalization.
• Works collaboratively with all members of the multi-disciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum, as well as appropriately reimbursed by payers as contracted, and that resources are efficiently and effectively utilized.
• Seeks the expertise of social workers to resolve psychosocial patient care issues and to develop complex patient transition/discharge plans as needed. Interacts with patients, family members, healthcare professionals, community and state agencies in this effort. Serves as an advanced clinical resource to the team.
• Serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information.
• The role is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) series and CMS guidelines.
• Utilizes medical necessity criteria as a tool to assess appropriateness of level and setting of care, assists in the denial and appeals process, assesses quality and identifies and reports potential risk management issues.
• Responsible for participation in and completion of all patient safety initiatives appropriate to the position.
• The incumbent conducts all job responsibilities according to VCUHS' Mission and Values.
• Responsible for establishing and maintaining a professional rapport with providers, patients/families, and internal customers.

Supervisory responsibilities (if applicable):

N/A

Additional position requirements:

Day and Evening shifts available

Age Specific groups served:

All

Physical Requirements (includes use of assistance devices as appropriate):

Physical: Lifting 20-50 lbs.

Activities: Prolonged sitting, Walking (distance)

Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking

Emotional: Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Able to adapt to frequent, change

Compensation Range

$73,133.00 - $120,744.00

Actual salary offers will be based on several key factors to include relevant work experience, credentials, and qualifications.

EEO Employer/Disabled/Protected Veteran