Patient Care Coordinator RN

Work Shift

Weekend Option

Scheduled Weekly Hours

24

Summary

This position supports Mercy's philosophy of patient centered care acting as an advocate to patients and their families. The Patient Care Coordinator works specifically with patients experiencing complex disease processes needing multiple sources of health care support. The Patient Care Coordinator provides clinically based holistic care coordination and discharge planning in the inpatient and outpatient setting.

Job Description

Job Duties

• 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
• Conducts peer to peer reviews with third party payors when necessary to ensure reimbursement.
• Follows Mercy's safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

Department Specific Duties

Care Coordination

• Communicates daily with physicians and clinical staff regarding the plan of care and progress towards goals
• Co-facilitates care conferences on assigned unit
• Ensures appropriate admission status has been documented applying InterQual Criteria and communicates effectively with physicians per Utilization Review process.
• Applies InterQual criteria for continued stay review to effectively manage length of stay and communicate effectively with commercial insurance reviewers.
• Provides clinical data/information to contracted third party payers while patient is hospitalized to ensure continued reimbursement and to avoid reimbursement delays.
• Completes case management assessment of patients and support systems in order to facilitate the most appropriate and timely transition plan.
• Seeks patients eligible for admission to the Transitional Care Unit and other appropriate referral organizations.

Knowledge, Skills and Abilities

• Sound background in complex nursing principles and procedures and demonstrated ability to provide safe and effective nursing care.