RN Care Coordinator: Chronic Illness & Transitions

Beacon Health System; Granger (IN); On-site; USD 65,000 - 90,000; Full time

Job summary

Beacon Health System in Indiana seeks a Care Coordinator to manage outcomes for a defined patient population across the continuum of care. You will collaborate with physicians, staff, patients, and families to ensure smooth transitions from hospital to home and to post-care settings.

Responsibilities include education, chart review, data reporting, and supporting discharge planning, with emphasis on improving quality and cost outcomes. RN licensure and chronic-disease experience are required.

Qualifications

• The level of knowledge, skills and abilities normally acquired through the successful completion of a Baccalaureate Degree in Nursing or related area.
• A master's degree is preferred.
• Current RN license in the State of Indiana, minimum three years related clinical experience and experience in educating and managing various chronic illnesses.

Responsibilities

• Coordinate and manage outcomes of a specific patient population across the continuum of care.
• Assure smooth transition from hospital to home to physician visits.
• Network with physicians and other health care providers to implement plans of care and achieve desired patient outcomes.
• Educate and refer patients with chronic illness to manage conditions.
• Assist physician as liaison between family and interdisciplinary team.
• Monitor patient care and track variances.
• Refer variance trends for review and action.
• Assist with discharge planning and coordination of community services.
• Review patient records for completeness and accuracy.
• Coordinate gathering and reporting of patient outcome information post discharge.
• Contribute to continuous quality improvement through data analysis and reporting.
• Prepare summaries and reports for managers and executives.
• Complete mandatory education and maintain licenses and certifications.

Skills

Nursing assessment

Chronic disease management

Clinical care

Communication skills

Interpersonal skills

Analytical thinking

Problem solving

EHR proficiency

Time management

Education

Baccalaureate Degree in Nursing

Master's degree preferred

Tools

Electronic Health Records (EHR)

Word processing

Spreadsheet

Job description

Beacon Health System in Indiana seeks a Care Coordinator to manage outcomes for a defined patient population across the continuum of care. You will collaborate with physicians, staff, patients, and families to ensure smooth transitions from hospital to home and to post-care settings.

Responsibilities include education, chart review, data reporting, and supporting discharge planning, with emphasis on improving quality and cost outcomes. RN licensure and chronic-disease experience are required.