Job Summary The Nurse Care Coordinator works within the interdisciplinary team and the provider to ensure linkage to appropriate medical and behavioral health treatment and resources. Duties - Perform a comprehensive assessment and screenings of a patient's clinical, psychosocial, and health issues and disparities in treatment
- Establish rapport and a relationship with the patient and family in order to understand their needs and expectations and to assist them in setting realistic and mutual goals
- Integrate an awareness of cultural factors in the patient/family interview process, elicit clinically relevant cultural information
- In conjunction with the physician, the patient and interdisciplinary team, establish a comprehensive plan of care to appropriately address clinical milestones
- Communicate plan of care, including changes and issues related to plan of care to patient/family, physicians, and other members of the healthcare team
- Gather sufficient information from all relevant sources to determine the effectiveness of the plan of care to ensure it is done in an accurate, safe, timely, and cost-effective manner
- Coordinate patient transfer to the appropriate level of care
- Identify and facilitate resolution of clinical and operational roadblocks to achieve optimal outcomes by identifying alternatives as needed
- Document all care management assessments and interventions.
- Add current discharge planning documentation into medical records
- Follow up to ensure that tests and treatments are proceeding efficiently and that results are available to physicians on a timely basis
- Closely monitor the progression of care for the observation patient, ensure appropriate utilization of resources and efficient throughout
Skills/Abilities: - Excellent interpersonal skills, including demonstrating empathy and compassion
- Skills and ability to complete health screenings and provide nursing interventions
- Ability to engage clients and families
- Ability to work collaboratively in a multi-disciplinary team
- Excellent time management skills with a proven ability to multitask
- Excellent analytical skills
- Ability to function well in a high-paced and at times stressful environment
- Proficient with electronic health record and computer programs
Requirements: - RN/BSN with State of Illinois
- 1-2 years' experience working in a healthcare setting, preferably in care coordination
- Preferred experience working with behavioral health clients
- 25% 50% of time spent walking or standing, travel 10%
- Potential exposure to infectious disease or violence
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