RN Care Coordinator – Care Coordination Department – PRN
UT Southwestern Medical Center University Hospital Care Coordination.
This position integrates national standards for case management scope of services to include a process whereby screening/identification, assessment, planning, sequencing of care and communication is completed to ensure a safe and timely transition to the next level of care.
The candidate will need to possess knowledge related to federal, state, local hospital and accreditation requirements that impact scope of services to include, Centers of Medicare and Medicaid Service’s (CMS) Condition of Participation.
This position coordinates discharge planning that begins at the time of admission and is reevaluated and adjusted throughout the patient’s hospital stay. RN Care Coordinators will arrange and ensure all elements of the transition plan are implemented and communicated to key stakeholders including, but not limited to, the health care team, patient/family/ caregiver, and post-acute providers.
Minimum 3 years’ experience as staff nurse in the acute care hospital setting. CCM or ACM certification preferred.
Experience and Education
- Three years’ experience as a RN in specialty area. (General hospital level care experience ).
- Graduate of an accredited Nursing program,
- BSN preferred.
- Must be able to read, write and communicate in English.
- Current Texas (or BNE Compact State) license; current Basic Life Support (BLS).
- Leads multidisciplinary team developing, refining, updating, and communicating plan of care for defined patient population.
- Implements clinical pathways including educational needs of patients/families, monitoring and updating for deviation from plan.
- Partners with community liaisons to proactively manage care transitions assuring seamless transitions between care settings and communications with ongoing providers.
- Collaborates with Social Work, Utilization Review, Clinical Documentation Specialists, and others as necessary to maximize financial/care resources for patient and family.
- Coordinates care with care team to maximize patient throughput and minimize length of stay.
- Rounds on patients daily to monitor & assure effective patient/family preparation for discharge assuring completion of learning/discharge objectives prior to time of planned discharge.
- Communicates effectively with other health care providers, patients, families, other hospital personnel and visitors. Demonstrates effective communication with adolescents, adults and older adults.
- Act as a liaison with various departments and ancillary services to ensure all pending orders and results are received in a timely manner.
- Ensures follow up appointments are scheduled prior to patient discharge. Responsible for ensuring that discharge instructions related to care coordination needs are documented in discharge instructions and that those elements are understood by patient and family/caregiver.
- Collaborates with physicians, unit manager, unit staff, and interdisciplinary team to ensure safe and timely discharge.
- Performs discharge planning and care coordination for patients as they transition from the hospital setting to the outpatient setting.
- This position assists with patient discharge goals, establishing a discharge plan, communicates and works with the care team, arranges and coordinates DME procurement, SNF, LTAC and IPR placements.
- This position also arranges Home Heath and any other OP services to include transportation and identifies and works closely with the in-network providers with the patients’ health insurance plan.
- Care Coordinators also work diligently to be in compliance with the Conditions of Participations, Discharge Planning and throughput.
- Performs other duties as assigned.
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. In accordance with federal and state law, the University prohibits unlawful discrimination, including harassment, on the basis of: race; color; religion; national origin; sex; including sexual harassment; age; disability; genetic information; citizenship status; and protected veteran status. In addition, it is UT Southwestern policy to prohibit discrimination on the basis of sexual orientation, gender identity, or gender expression.