Job Details

Care Coordinator- Care Coordination and Discharge Planning

  2018-12-18     Mercy Cedar Rapids     Cedar Rapids,IA  
Description:

# This position supports Mercy#s philosophy of patient centered care acting as an advocate to patients and their families. The care coordinator works specifically with patients experiencing complex disease processes needing multiple sources of health care support. The Care Coordinator provides clinically based holistic care coordination and discharge planning in the inpatient and outpatient setting for assigned accountable care organizations. # Job Specific Duties/Essential Functions Complex care review of patient status Develops an understanding of referral sources for assigned caseload Collaborates with other programs and departments Assists in the teaching needs for patient and families as needed Ability to work with a variety of personalities, character or ability Serves as a liaison between physicians and departments to ensure timely and quality care delivery Position Specific Job Duties/Essential Functions Facilitate patient-centered clinical access and care coordination throughout the healthcare continuum Develop a plan of care that reflects identified problems and incorporates age related issues while supporting the patient#s personal health goals Monitor patients# health status for ongoing clinical and transitional care needs Case manage individuals with complex medical and psychological conditions Collaborate with health care professionals (managers, administrators, schedulers, providers and other care coordinators/navigators) to facilitate a smooth transition of care Coordinates timely medical and ancillary care services based upon evidence-based clinical practice guidelines Provide clinical information to relevant clinical team members regarding patient needs and/or newly identified issues Facilitate gathering of external medical records and radiology films for placement in EMR Serves as clinical resource to social services and other care coordinators between transitions of care settings Demonstrates knowledge of hospital and community resources for age- and diagnosis-related issues Uses evidence-based clinical body of knowledge and an understanding of human behavior to support patient-centered issues Knowledge, Skills and Abilities Sound background in complex nursing principles and procedures and demonstrated ability to provide safe and effective nursing care. Ability to communicate well orally and in writing; via phone, email and face to face; establish rapport with clients/patients. Self starter; able to initiate and direct own activities in an organized manner, and make decisions within the framework of the responsibility and authority of the job. Professional Experience# Required vs. Preferred Minimum of three years of nursing experience, case management experience preferred. Education-Required vs. Preferred Bachelor of Science in Nursing required. Licensure, Certification, Registration - Required vs. Preferred Basic Cardiac Life support in accordance with the American Heart Association. Current RN licensure in the state of Iowa required. Physical Activity Requirements Constant = 67-100% of workday Fingering Hearing ## Frequent = 34-66% of workday Sitting Standing Walking Talking Repetitive motion ## Occasional = 33% or less of workday Reaching Lifting Balancing Stooping Kneeling Crouching Pushing Pulling Grasping Feeling Climbing Handling ## Physical Demand Requirements Light: Exert up to 20 lbs. of force occasionally and/or up to 10 lbs. of force frequently


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