RN Care Coordinator

This position focuses on an area of a specific medical specialty or chronic care condition (i.e. endoscopy, enterostomal therapy, mental health, total parenteral nutrition, bone marrow transplant). Serves as a resource and educator to patient, medical and hospital staff within the specialty. Coordinates care efforts for a safe, effective, efficient and patient centered transition along the health continuum. Provides pro-active disease management using evidence based practices. Acts as a liaison between patient/family, medical staff and others involved in treatment, promoting patient centered care based on jointly determined health care goals and priorities.

Identifies particular needs and implements quality standards of nursing care in area of clinical specialty.

· Accesses, analyzes, plans and provides follow-up care.

· Facilitates timely referrals and fosters positive relations with community providers.

Evaluates and documents status and follows patient progress through phone calls, test results and report preparation. Evaluates quality of nursing care via patient rounds.

· Identifies problems that are specific to the clinical specialty.

· Provides pro-active disease management using evidence based practices.

Serves as a liaison between patient/family, medical staff and others involved in treatment, promoting patient centered care based on jointly determined health care goals and priorities

· Collaborates with appropriate staff to provide coordinated transition of care across the healthcare continuum.

· Facilitates timely referrals and fosters positive relations with community providers.

Provides direct patient care in the area of specialty.

· Establishes individual nursing care plans.

· Provides education, counseling, medication management, and general health information to patients and patient representatives.

· Triages patient concerns and responds to patient concerns between visits under provider direction, to reduce relapse or inpatient care.

Functions as a resource to patient care units, outpatient clinics and medical staff regarding the clinical specialty.

· Identifies need and assists in writing and implementing policies and procedures.

Provides education services to patients and their families and other hospital staff regarding the clinical specialty. Develops content, resource materials and coordinates the educational plan.

Serves on task forces and committees related to the clinical specialty.

· Keeps up to date on technological advances and new pharmaceutical products.

· Consults with other areas regarding specialty.

Assists with research projects which may include collection data, data analysis and evaluation. May identify research projects.

· Manages database to track patient outcomes and other specific categories as directed by physician.

· Promotes program and assists with marketing efforts. Oversees or manages prior authorization process and results verification process to ensure positive image.

· Provide effective educational material.

· Serves as a community liaison.

· Performs other duties including Performance Goals developed by manager and employee and reported in the employee’s Performance Review as part of UMPhysicians’ Performance Management tools

· Develops and maintains critical competencies listed in this job description and the competencies drop down list in the employee’s online performance management tool.

Organization Expectations, as applicable:

· Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.

o Partners with patient care giver in care/decision making.

o Communicates in a respective manner.

o Ensures a safe, secure environment.

o Individualizes plan of care to meet patient needs.

o Modifies clinical interventions based on population served.

o Provides patient education based on as assessment of learning needs of patient/care giver.

· Fulfills all organizational requirements.

o Completes all required learning relevant to the role.

o Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.

· Fosters a culture of improvement, efficiency and innovative thinking.

· Performs other duties as assigned.

Required

Education

Experience

· Three years of specialty experience doing care coordination. Or licensed RN with five years of clinical experience and ability to learn new specialty area.

License/Certification/Registration

· Licensed RN in State of MN

· BLS within 30 days of orientation ***this requirement does not apply to dept 8901 Ambulatory Care Coordination

Preferred

Education

· Licensed RN with four year Baccalaureate Degree

Experience

· Two years of RN experience in the specialty area or previous care coordination experience.

License/Certification/Registration

· Specialized knowledge of the specialty and conditions of served population.