RN Full-time
St. Joseph's/Candler

RN Care Coordinator

St. Joseph's/Candler Baxley, GA 31513, US
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  • Position Summary
    • Performs comprehensive in-home nursing assessments of both current and potential patients. Develops, reviews and updates care plans based on patient needs. Responsible to provide clinical support to care coordination team and other assessment nurses as needed. Assist with quality monitoring, regulation compliance, and performance improvement initiatives as needed. Serve as a positive and productive member of a multidisciplinary care coordination team.
  • Education
    • Bachelor's of Science in Nursing - Required
  • Experience
    • 1-2 Years at least one: Geriatric , chronic of adults, Long term care, community health, and home health- Preferred
  • License & Certification
    • Registered Nursing License with State of Practice - Required
  • Core Job Functions
    • Schedules and completes in-home assessments using tools and criteria established and required by the Department of Community Health. Using professional judgment, provide a preliminary determination whether or not an individual meets program requirements. Responsible for completing all required paperwork and data entry regarding the assessments timely and accurately. Understand the importance of patient satisfaction and excellence in customer service and how these affect the patient's experience.
    • Create and review comprehensive care plans based on the assessment findings initially and during annual reassessment to address patient risks/needs and establish goals for the patient. Demonstrate knowledge and skills necessary to identify patient needs. Assist with care coordination to achieving positive outcomes.
    • Provide clinical guidance to the multidisciplinary care management team to achieve successful outcomes. Actively participate in care coordination planning and review with the multidisciplinary team while maintaining positive and productive working relationships.
    • Attend and participate in program specific training and educational opportunities. Maintain program specific knowledge of policies and protocols. Assist with training other staff as needed.
    • Supervise and verify the assessment documentation and information obtained by licensed practical nurses is clinically accurate and complete. Review and certify the level of care placement instrument as needed. Collaborates with the care coordination team on the development of the patient's care plan initially and annually thereafter.

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