Rn care coordinator

Company Name:
Dignity Health
# Job ID
: 1400010540) - 301-RECOVER-ST ROSE
About This Position
The St. Rose Quality Care Network (SRQCN) is a clinically integrated physician network. The RN Care Coordinator is an employee of Inland Health Organization of Southern California, Inc., doing business as MedProVidex, a physician support organization owned by Dignity Health.
The goal of care coordination is to assist in managing care, cost, and outcomes in the nursing facility environment. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services. Care coordination principles provide an opportunity to balance care with cost. The SRQCN care coordination program's purpose is to promote efficiency, efficacy, and effectiveness of services for patients. The long-term goal of the program is to classify all patients into case management categories (complex, routine, etc.) and assign them to RN care coordinators or social workers, based on acuity and need.
The RN Care Coordinator plans and coordinates all phases of ambulatory care coordination using a problem solving process that includes assessment, problem identification, goal definition, plan development, evaluation to achieve optimum patient outcomes. This position requires a successful track record of interaction with physicians, staff, patients and their families, as well as all aspects of patient care management including referral development, assessment of patient clinical needs, and coordination of the interdisciplinary plan of care.
Concurrently reviews patient's records to collect data to carefully understand the needs of the patient by scrutinizing their background history, understanding their current needs, and arranging for their wellbeing.
Using industry guidelines, assesses appropriateness of hospital admission, level of care, and length of stay.
Completes a comprehensive clinical interview with the patient, family members and/or care giver identifying problems or opportunities that would benefit from case management intervention such as over-utilization or under utilization of services, use of inappropriate services or level of care, non-adherence to plan of care, lack of education or understanding of disease process, language or cultural barriers, current condition(s) or medications, functional limitations, lack of support system or presence of a support system under stress, financial barriers, compromised client safety.
Evaluates patients overall risk using risk stratification tools and determines if meets routine case management or complex case management criteria.
Assesses physical, psychosocial and other needs to ensure individualized care plan captures patient''s current healthcare needs, determining when Social Worker interventionis needed.
Reviews medications and recognizes potential medication discrepancies and barriers referring to and coordinating with pharmacist in managing patient medication needs.
Coordinates with other disciplines to facilitate the patient's individual needs. Makes plans to resolve unexpected care requirements. Anticipates and identifies variances in the care process related to those identified needs.
Assists in development, implementation and revision of individual treatment plans; assures that services provided are specified in the Treatment Plan and monitors progress toward treatment goals, including documentation of daily improvement in patient's condition or otherwise notes lack of improvement for reassessment of appropriateness of treatment plan.
Communicates with the primary care and specialist physicians, regularly, to evaluate the status of each patient. Collaborates with other team members to ensure appropriate interventions are implemented.
Measures effectiveness and outcomes of the care plan and collaborates with the health care team for quality improvement (primary care physician, social workers, pharmacists, home visit providers, care coordination support staff).
Teaches, coaches and educates the patient, family and/or caregiver about their disease process to recognize signs and symptoms of worsening disease and how to take appropriate measures.
Has a working knowledge of the financial aspects related to a variety of payer sources.
Reports weekly to the Executive Director regarding patient status and identifies any potential risk management.
Maintains case files and reports.
Minimum 2 years experience as a Case Manager in a hospital, nursing home, medical group, or health plan setting. Bachelor Degree in Nursing; Current Registered Nurse License in Nevada.
About Us
In business since 1993, Inland Health Organization of Southern California, Inc., now doing business as MedProVidex, is a wholly-owned subsidiary of Dignity Health. MedProVidex is a physician support organization that has historically provided physician practice and IPA management, but has expanded to support the infrastructure for Dignity Health's Clinical Integration networks. In this capacity, MedProVidex will provide local and corporate support resources to the Southern California Integrated Care Network (SCICN), the St. Rose Quality Care Network (SRQCN), Arizona Care Network (ACN), Sequoia Quality Care Network (SQCN), and future networks. MedProVidex is licensed to do business in California, Arizona and Nevada.
Organization: MedProVidex
Primary Location: Nevada-Las Vegas Service Area-Henderson-SRQCN
Work Locations: SRQCN 2865 Siena Heights Drive Suite 300 Henderson 89052
Number of Openings: 2
Area of Interest: Case Management / Utilization Review
Req ID: 1400010540

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