Registered Nurse Case Coordination Family Medicine Family Medicine Center Heart & Vascular Cen

Registered Nurse Case Coordination Family Medicine – Family Medicine Center – Heart & Vascular Center (Job )

Location: US: WV:
Charleston

Employment Type: Employee

Post Date: 7/2/2026

Job Summary

Coordinate patient needs to assure high quality patient care, reduce length of stay; resource utilization; ensure reimbursement drawing on a broad clinical and systems management knowledge.

Responsibilities

• Collaborate with the medical staff and serve as a resource expert regarding documentation, application of appropriateness criteria, alternate levels of care, patient classification, denial information and payment information. Includes collaboration with Physiatrist and Medical Director.
• Facilitate communication with patients, physicians, and families in order to avoid insurance and Medicare denials. Provide information regarding services available to add family/patient in making informed decisions.
• Direct the timely implementation of the plan of care in collaboration with the multidisciplinary team. Serve as a liaison to ensure that all elements critical to the plan of care have been communicated to the patient, family, and members of the multidisciplinary team.
• Educate multidisciplinary team regarding documentation in order to assure continuity of care and hospital/physician reimbursement for all services.
• Utilize assessment skills to identify and anticipate discharge and other needs of patients/families.
• Evaluate care based on standards of care and QI process of selected population or unit.
• Act as a resource to assist others with patient care management.
• Ensure patient rights are sustained and safeguard patient privacy and confidentiality.
• Coordinate utilization and implementation of internal and external resources.
• Facilitate group process and interdisciplinary problem solving.
• Monitor trends and report practice issues of the multi‑discipline health care team that impacts finances and quality care issues. Implement appropriate measures to resolve issues.
• Provide input to department managers on the quality of care which is being provided in the departments (ex: nursing, ancillary).
• Monitor and review quality care issues being provided on a unit level with Department Manager, Clinical Physician Director, and Clinical Quality Specialist.
• Direct attending and consulting physicians, residents, staff nurses and other members of the multidisciplinary team to address system processes that impact the timely delivery of care.
• Collaborate with all members of the multidisciplinary team to facilitate the case coordination process for designated case load. Monitor the patient's progress, intervening as necessary and appropriate, to ensure the plan of care and services provided are patient focused, high quality, efficient, and cost‑effective.
• Support Collaborative Practice Committees and develop methods to optimize resource utilization in order to achieve quality outcomes.
• Collaborate with multidisciplinary team to identify patient needs, assess patient progress against the care map, address family and patient discharge needs and make appropriate referrals to address those needs. Facilitate identified improvement processes are appropriate. Assist the Physiatrist or manager‑medical director for post‑acute services.
• Assist with development and tracking of quality indicators and collection of variance data.
• Apply variance tracking data to facilitate system changes or changes in practice, and facilitate quality management activities including screening, focus studies, and others.
• Recommend improvements based on variance tracking.
• Identify educational needs of the staff and physicians and provide continuing education.
• Participate in hospital/unit committees as requested.
• Maintain communication with patients, families, and visitors to ensure high level quality care for patient satisfaction.
• Keep the patient's medical record current.
• Integrate continuous, quality improvement into department and institution operations, and demonstrate a commitment to the process.
• Serve as patient/family advocate.
• Initiate collaborative action toward identified barriers to quality.
• Post‑Acute Services specific: complete the pre‑admission screening, document…