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17596BR

Title:

RN Care Coordinator

Department/Cost Center:

771 - Social Work Service

Job Description:

Highland Hospital is seeking an experienced RN to join the Care Management team.

Care coordinators are responsible for coordination of interdisciplinary care planning to achieve timely and safe discharge to home, skilled nursing facility or other area necessary.

Essential Job Duties include:

. Clinical Practice Responsibilities:

1. Leads interdisciplinary care planning:

1.

1. Completes comprehensive assessment of patient/family needs and capabilities to support care needs post hospitalization.

2. Identifies factors critical to achieving required outcomes for discharge, post-hospitalization recovery and health maintenance.

3. Ensures interdisciplinary medical record documentation of patient progress toward goals for all patients followed

4. Disease specific management to reduce readmissions.

5. Identifies goals and usual patterns of care for specific groups of patients.

6. Uses data to develop and implement strategies that reduce length of stay and resource utilization and facilitate patient flow.

2. Collaborates in patient care planning process by:

1. Participation in daily health team rounds.

2. Facilitating discharge plans, including acquisition of medications, supplies and equipment.

3. Identifying discharge barriers and working toward overcoming them to achieve timely and safe discharge.

4. Identifies community resources and Primary Care Management to assure handoff of patient information.

5. Utilizes the Longitudinal Plan of Care to access patient information and update information based on hospitalization.

6. Assure completion of Community Agency Choice letters and Advance Directives.

7. Facilitating timely referrals to Community Home Health Agencies and facilitie

3. Educates nursing staff in matters related to disease-specific patient education compliance.

Salary Range:

$77,220.15- $93,600 annually

_he referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job’s compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations._

Auto req ID:

17596BR

Job Requirements:

1. Education –Fulfilled the educational requirements to be a licensed RN in NYS; BSN preferred

2. Experience 2 plus years professional nursing experience. Progressive clinical experience including: community health, care management, and/or disease management is preferred. Experience working as a member of a multi-disciplinary team is required.

3. License/Certification Required- Licensed to practice nursing in New York State; PRI certification a plus

Employment Status:

Full-Time

Hours/Week:

40/week

Posting Title:

RN Care Coordinator

City:

Rochester

Work Shift:

Days

Area of Interest:

Nurses

The Hospital is committed to equal opportunity for all persons regardless of age, color, disability, ethnicity, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by law.