• RN Care Coordinator

    Job ID
    2018-24752
    Employment Type
    full-time
    Hours Per Week
    40
    Onsite Work Schedule Details
    M-F 8-430p every 3rd weekend
    Address
    350 7th Street North
    City
    Naples
    State
    FL
  • Overview

    The RN Care Coordinator leverages professional nursing skills to assess patient needs, the clinical appropriateness of treatment for the setting and establish plans for effective management through the continuum of care. An RN Care Coordinator educates staff regarding effective allocation of hospital’s resources while encouraging provision of high quality patient care. This role is knowledegable about the regulations and policies of all review organizations related to billing of third-party payers. 

    Responsibilities

    • Manages a coordination of care model for each assigned patient that is cumulative, complimentary and contiguous, using ongoing interaction with patients, physicians and other health providers to meet designated clinical, operational and financial outcomes for their assigned patients. Assists physicians, patients, families, staff and payers in managing care for assigned patients that is appropriate, effective and cost efficient.
    • Works in conjunction with the Utilization Review Team to confirm expected LOS and payer approved days. Keeps the physicians informed of the expected LOS and targets care coordination around meeting this goal LOS. Keeps the Manager of Care Coordination apprised of cases exceeding the LOS target.
    • Performs an initial assessment of patients within 24 hours of admission focused on immediate short term and transition of care needs to drive expected length of stay consistent with the patient’s working DRG.
    • Confers daily with the attending physician and consulting physician(s) to review and clarify clinical and utilization appropriateness of the treatment plan for assigned patients, attends dishcarge rounds prepared to discuss patient progress toward discharge and documents avoidable days in the Cerner UM Module.
    • Visits patients routinely to complete and maintain an assessment that accurately reflects the patients’ condition and response to the plan of care, keeps them informed of their rights as a patient and communicates discharge requirements with them, notifying the patient when their continued hospitlization no longer meets medical necessity for the hospital level of care.
    • Follows through with planned interventions and documentation to assure appropriate use of health care resources and take appropriate action to facilitate discharge when a patient fails to meet medical necessity criteria, including independently in identifying the need for HINN, HRR, and IM.
    • Identifies the need for patient notifications; including, HINN, HRR and ABN. Notifies Care Coordinator Manager anytime such a medical necessity notice is presented to a patient.
    • Stays abreast of changing length of stay, readmissions, case management, regulatory matters and third party payer requirements. Manages all aspects of the readmissions stratification, prevention and action planning.
    • Identifies patients who will benefit from the assistance of financial counselors.
    • Collaborates with the patient, the patient’s third-party payer and Utilization Review Team to identify post-acute care options that meet patient needs and assist with information necessary for the Utilization Review Team to obtain timely authorization(s) for services both during and after the patient’s hospitalization.
    • Educates staff regarding effective allocation of the hospital’s resources while encouraging provision of high quality patient care.
    • Participates in a regular rotation of weekend and after-hours coverage in order to meet staffing needs.
    • Supports nThrive’s Compliance Program by adhering to policies and procedures pertaining to HIPAA, FDCPA, FCRA, and other laws applicable to nThrive’s business practices. This includes: becoming familiar with nThrive’s Code of Ethics, attending training as required, notifying management or nThrive’s Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations.

    Qualifications

    • Bachelor's degree in nursing (BSN) or Associate degree in nursing.
    • Licensed as a Registered Nurse in the State of Florida
    • 3+ years of direct patient care experience as a registered nurse.
    • Strong written and verbal communication skills.
    • Knowledge of MS Office products such as MS Word and MS Outlook.
    • Ability to evaluate medical records and other health care data.
    • Effective and professional presentation skills.

    Preferred Skills

    • Certification in care coordination or utilization review.
    • Prior experience as an RN Care Coordinator.

    About nThrive

    Be Inspired. Ignite Change. Transform Health Care. 

    From Patient-to-PaymentSM, nThrive provides all the technology, advisory expertise, services, analytics and education programs health care organizations need to thrive in the communities they serve. Our colleagues share a united passion to help health care organizations strengthen their financial position, which translates to accessible, quality care for all. This passion fuels our drive to innovate and participate in community outreach through the nThrive CARES program. Our colleagues are encouraged to think differently and empowered to make a lasting impact that ensures our health care providers, and our world, are healthy and productive.

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