Registered Nurse (RN) -Acute Care - Care Coordination- FT Days

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Day (United States of America)

Come join our Cobb Hospital Care Coordination team!

About the Facility

Learn more about Wellstar Cobb Hospital
, including our teams, culture and campus environment:

Hours:

FT Days

Minimum 3 years of experience in healthcare in the acute care setting, related field, skilled care or community environment in care coordination.

Minimum 2 years in care coordination in the acute care setting required.

Relocation assistance for eligible candidates

Job Summary:

The RN Complex Care Coordinator is responsible for assessing complex patient transitional care needs, coordinating care across the continuum, and engaging with patient and family to assure care needs are met. Serves as an expert resource for complex patient and situations and serves as a consultant to the other care team members regarding patient's clinical, psychosocial and resource needs. In conjunction with the patient and physician, the Complex Care Coordinator assesses, coordinates, and implements a timely, safe patient discharge plan to the next appropriate level of care.

Overall, this role draws on the strong clinical and social expertise of the Care Coordinator to integrate and coordinate the most challenging patients transitional care plans based on needs and resources available.
Specific functions within this role include:
Responsible for providing comprehensive clinical and psychosocial assessments for complex patients (high risk of readmission, high cost, long stay, and/or difficult to place) to include timely and appropriate planning to advance the discharge plan.
Carries appropriate caseload of select complex patients as specified by hospital criteria, providing all care coordination responsibilities in coordination with the patient care team.
Participates in the interdisciplinary team providing information about community-based service offerings (e.g.

-indigent services, housing, social referrals and assistance, specialty care or post-acute placements, elder assistance, etc.) and offers guidance to patients/families to assist with multi-system factors that affect patient/family psychosocial dynamics.
Serves as a specialist on issues related to complex psychosocial and discharge needs, end of life care planning, resource needs, etc. Will provide resource information necessary to aid patient/families in decision making up to and including support for end of life.
Partners and serves as an expert resource to other Care Coordinators and interdisciplinary team members concerning complex social determinants of health issues, financial, legal, situational dynamics, and social needs.
Participates in precepting of new care coordinators (as needed) to teach and expose them to the most complex patient care needs and family dynamics. Mentor other care coordinators in case reviews and discussion of difficult situations, to include, but not limited to patient legal status, court regulations, financial options, suicidal ideation, grief and bereavement, social determinants of health, cultural or language barriers, abuse cases (both children and adult), along with many other scenarios.
May serve as facilitator of hospital team meetings to reduce the length of stay and resource consumption of complex patient population.
Supports leaders in negotiating agreements with community agencies and facilities.

May have other duties assigned as it relates to hospital complex patient population

Core Responsibilities and

Essential Functions:



Complex Disposition Planning
a. Implements discharge planning and provides resource information in a timely and efficient manner for complex patients.
b. Identifies and documents barriers for timely disposition.
c. Understands…