RN Clinical Care Coordinator - Denver Health (* Weekly Hybrid Schedule Requirement *)

Denver Health Lincoln Park, CO 80203, US

$84,100 - $130,400 / year

We are recruiting for a mission-driven RN Clinical Care Coordinator - Denver Health (* Weekly Hybrid Schedule Requirement *) to join our team!

We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in—it’s something we live every day, for life’s journey.

Our Values

Respect | Belonging | Accountability | Transparency

Department

Managed Care Administration

Job Summary

Under general supervision, the Transition Care Coordinator (RNCC) is responsible for facilitating and coordinating the care delivered to an assigned group of members through multidisciplinary and member/family collaboration to ensure quality and cost effective outcomes are delivered within appropriate care coordination parameters. Coordination involves assessment, planning, support, and evaluation of member care and related outcomes. Activities to be performed are screening and assessment of medical, behavioral health and social determinants needs and gaps in care, collaboration with the Member to develop a care plan with SMART (SMART goals are: Specific, Measurable, Attainable, Relevant and Timely) goals, periodic outreach within defined timeframes to support member in achieving their goals and supporting the Members self-efficacy to navigate systems. RNCC communicates closely with the Member's care team inclusive of: the member, the member's designated health representatives, primary care provider, behavioral health providers and other care coordinators involved with the Member's care.

Essential Functions:

Use DHMP Care Management protocols and critical thinking to assess, identify opportunities to improve Member healthcare outcomes, collaboratively set SMART goals with the Member, develop a care plan with interventions and support and enable the Member to achieve their goals and independently navigate needed services to improve overall health outcomes. (10%)
Visit members with complex needs in community based settings, including community centers, hospitals or providers' offices. (10%)
Provide a complete continuum of quality care through close communication with members via in-person, phone or electronic interaction. (10%)
Support members with education relevant to their disease process, medication reviews and connections to community resources such as food, housing or financial support programs. (10%)
The RNCC will work with members with complex needs, prioritize care management and work with a multidisciplinary team to support the needs of the Members on their caseloads. (10%)
Document in readable, understandable language according to professional, regulatory, and agency standards. (10%)
Document and disseminate results of care to member, caregivers, and others involved in the care or situation, as appropriate, in accordance with contractual requirements, state and federal laws, regulatory requirements, and Denver Health policy. (10%)
RNCC will be responsible for a defined caseload of Members identified as needing Complex Care Management (CCM) or Population Health Management/Disease Management (PHM) services. (10%)
Members meet the threshold for CCM by meeting defined threshold conditions, including multiple chronic physical health and/or behavioral health conditions, polypharmacy, high costs of care, avoidable use of high cost services and/or associated social health disparities. (10%)
Members meet the threshold for PHM by having at least one of several defined conditions, including a chronic physical or behavioral health condition, like diabetes or depression; a person with special health care needs; high-risk pregnancy or other identified condition. (10%)

Education:

Associate's Degree Nursing required

Work Experience:

1-3 years of clinical experience in a hospital, acute care, home health/hospice, direct care or case management required required
1-3 years of experience in care coordination or case management required required

Licenses:

RN-Registered Nurse - DORA - Department of Regulatory Agencies required

Knowledge, Skills and Abilities:

Must have reliable transportation to travel to community-based locations within the Denver-metro area.
Bilingual ability English/Spanish.
Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action.
Ability to communicate verbally and in writing complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
Knowledge of health plan case management, care coordination, or member navigation.
Medicaid and Medicare Managed Care knowledge.
Skills working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs.
Knowledge and understanding of case management/coordination of care principles, programs, and processes in either a hospital or outpatient healthcare environment.
Ability to collaboratively support team members and/or staff to achieve pre-determined goals. Effectively collaborate with and respond to varied personalities in differing emotional conditions, and maintain professional composure at all times. Strong customer service orientation and aptitude required.

* This is a hybrid role with a weekly in-office requirement.

Shift

Days (United States of America)

Work Type

Regular

Salary

$84,100.00 - $130,400.00 / yr

Benefits

At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development — while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you’re joining a mission-driven organization that invests in you.

Here is a small list of our benefit programs:

Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
100% paid parental leave up to 6 weeks
Immediate eligibility for retirement plans with employer contribution up to 9.5%
Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
Free RTD EcoPass (public transportation)
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer

About Denver Health

Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation.

As Colorado’s primary, and essential, safety-net health care system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year.

Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.

Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.

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(50%) Patient Assessment Assess the needs of individuals, families and/or communities to identify potential health or safety problems, Instruct individuals and families on health education and disease prevention and after care. (20%) Treatment and Evaluation Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care. Monitor all aspects of patient care, including diet and physical activity, develop and modify patient care plans as indicated by patient’s responses and conditions. Prepare patients for, and assist with examinations and treatments (20%) Medication administration, documentation and reassessment (10%) Education : Associate's Degree in Nursing Required Work Experience : 1-3 years Professional nursing experience in a patient care setting. Required Licenses : RN-Registered Nurse - DORA - Department of Regulatory Agencies Required and BLS-Basic Life Support (BLS/CPR) - AHA - American Heart Association Required Knowledge, Skills and Abilities : Adherence to Standards of Professional Nursing Practice/ Process / Performance [ANA Standards addendum- signed] and accrediting body standards. Strong understanding and display of the principals of customer service as it applies to patients, staff and the community. Ability to assist in identifying ways to promote quality patient-centric care and maintain Denver Health’s high level of patient satisfaction. [Nursing Vision Statement] Ability to work effectively in a team matrix environment. Ability to communicate clearly and effectively at all levels and in a cross functional environment. Ability to work closely with multidisciplinary staff, medical assistants, patient access specialists, health educators, care navigators, social workers, Nursing Managers, providers, and, executive leadership to provide care to patients with respect to their uniqueness using informed judgment, competence, individual qualifications, and collaboration with the health care team. Ability to demonstrate an understanding of assessment findings as they relate to the disease process and optimal health attainment across the continuum of care. Proficient in EHR Basic Office Suite skills preferred Shift Work Type Regular Salary $38.42 - $59.55 / hr Benefits At Denver Health, we take care of the people who take care of our community. Our benefits are built to support your life, your family, and your future — with generous paid time off, fully paid parental leave, exceptional retirement contributions, comprehensive health coverage, and nationally recognized well-being programs. We invest in your growth through tuition assistance, career advancement pathways, and professional development — while also offering meaningful financial advantages through loan forgiveness eligibility and employer contributions. When you join Denver Health, you’re joining a mission-driven organization that invests in you. Here is a small list of our benefit programs: Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays 100% paid parental leave up to 6 weeks Immediate eligibility for retirement plans with employer contribution up to 9.5% Generous medical, dental, vision plans in addition to employer paid disability and life insurance. Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center Free RTD EcoPass (public transportation) Childcare discount programs & exclusive perks on large brands, travel, and more Tuition reimbursement & assistance Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways Professional clinical advancement program & shared governance Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer About Denver Health Denver Health is an integrated, high-quality academic healthcare system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, the Public Health Institute at Denver Health, Denver Health Medical Plan and Denver Health Foundation. As Colorado’s primary, and essential, safety-net healthcare system, Denver Health is a mission-driven organization that has provided millions in uncompensated care for the uninsured each year. Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer. Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Applicants will be considered until the position is filled.