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

Care Coordination Daytime Supervisor (RN FT Days - Cobb Hospital

The Care Coordination Supervisor assists with coordination of patient care across the continuum during the patient's acute hospitalization. The CC Supervisor supports initial assessments, transitional care planning, patient advocacy, complex issue resolution, and monitoring performance for defined quality outcomes resulting from the care coordination services provided. The CC Supervisor support the CC Manager or Director and collaborates with all team members to provide an efficient and effective coordination of care.

The CC Supervisor provides expert guidance in the following areas:

• Care Coordination comprehensive assessment and discharge (transition) planning
• Facilitative collaboration with multidisciplinary care team
• Effective and timely communication with care team and patient/family
• Challenging Conversations with patients/families
• Engagement with community agencies to ensure timely transfers and handoff of patient care
• Patient/family education/counseling regarding medical recommendations of his/her conditions
• Advance Directives
• Eligibility processes and criteria for both private and public, Local, State and Federal resources
• Community resource information
• Financial needs assessment for patients in need of assistance for follow-up care
• Supporting patient care inclusive of cultural or religious beliefs
• Monitoring and resolving avoidable hospital days
• Continuous performance improvement

Disposition Planning
* Oversight and guidance of Team Members:
* Implementation of effective and efficient discharge plan to include Plan A, B, C
* Effective collaboration with the multidisciplinary care team to streamline throughput and timely care delivery.
* Engagement with community agencies to ensure timely transfers and handoff of patient care.
* Provision of education/counseling to patient/family regarding medical recommendations of care.
* Responsiveness to referrals from hospital staff, physician offices, community and family to provide resource information
* Financial needs assessment for patients in need of assistance for follow-up care throughout the continuum

Leadership Duties
* Coordinate care with CC Manager/Director and other Healthcare Team Leaders.
* Oversee daily staffing assignments - evaluating daily work distribution regarding levels & demands of staff.
* Coach, mentor team members on general practice.
* Manage QA & PI activities
* Provide guidance during the new team member orientation and onboarding
* Provides objective input and feedback for yearly performance Assessment
* Oversight and Guidance of Team Members:
* Quality of initial care coordination assessments for use in planning for appropriate right care, right setting in post discharge needs.
* Team members assessments of insurance and financial ability to participate in community care after discharge.
* Identification of issues and barriers relating to patients appropriateness of hospital stay and discharge needs.

Documentation
* Oversight and guidance of Team Members:
* Initial psychosocial /functional assessment completed and documented in medical record.
* Complete chart notes accurately and timely per departmental protocol.
* Ensure all records are up-to-date and legible.
* Track and share avoidable days
* Identifies and provides training opportunities and continuous performance improvement for staff

Trust/Engagement (Mandatory Content)
* Builds a culture of trust and engagement as reflected in the Great Place to Work Trust Index Survey at a direct report, workgroup and hospital/entity level.
* Holds leaders accountable for behaviors that create trust and engagement.
* Performs all duties and responsibilities of this position in a manner that reflects the values of Well Star.
* Maintains and strengthens relationships with physicians and assures their involvement in developing systems to assure the growth of the service and the cost effective delivery of quality patient care in a manner that fosters patient and employee satisfaction.

Results Oriented Leadership (Mandatory Content)
* Sets challenging and productive goals for team.
* Holds team accountable for…