Disease Management Coordinator - Day

Job Title

Disease Management Program Coordinator

Full-time Day Shift

80 hours bi-weekly

Develops, implements and manages the Disease Management Program at assigned entity.

Identifies sepsis patients during their acute care stay and manages their care according to evidence based standards of care. Services as a liaison between the patients, families and healthcare team during hospitalization and the post-discharge period. Communicates to hospitalists and other hospital staff regarding abnormal findings in evaluation of patients and assesses readiness for discharge and risk for readmission. Administers follow up phone calls to all hospitalized Sepsis patients and addresses all problems that require attention to improve patient perception of care.

Coordinates transitions of care to the appropriate post-acute services.

Coordinates the sepsis program and initiatives locally, participates actively in implementation of changes recommended by the system CET.

Participates in the development, maintenance, implementation and evaluation of written care protocols based on evidence including physician orders, clinical pathways for expected length of stay and clinical practice guidelines.

Ensures data is collected, reviewed and analyzed monthly. Develops and implements action plans accordingly based on outcomes data. Collaborates with other disciplines using an integrated approach toward achieving optimal patient outcomes. Evaluates the impact of Social Determinants of Care on patient outcomes.

Develops and implements the patient education process for all hospitalized Sepsis patients with emphasis on symptom recognition, risk factor modification and structured Care Coordination. Revises and monitors educational materials to ensure that they are coordinated, understandable and meet the program standards.

Serves on/leads a Sepsis committee at the entity level and participates on the system CET. Prepares agenda and progress reports for the team that discusses readmission, length of stay and bundle compliance, identifies outcome measures that have not been met. Develops, implements and evaluates action plans for improvement with the team.

Develops, coordinates and participates in community awareness programs about Sepsis Awareness and Management annually. Participates in Community based education for other outside groups to enhance patient care beyond the acute care facility.

Role models critical thinking by demonstrating active and proactive problem solving.

Coordinates staff education and maintains clinical competencies related to sepsis patient care.

Bachelors Degree Nursing (BSN) Required

3 years Nursing with 2-3 years of inpatient acute care. Required and Medical/Surgical, Critical Care or Emergency Care experience. Required Critical or intermediate care experience, experience caring for COPD and Pneumonia patients. Preferred

Licensed Registered Nurse Upon Hire Required or Registered Nurse Multi State License Upon Hire Required and Basic Life Support Upon Hire Required

Strong organizational and prioritization skills preferred.

Benefits Offered:

• Comprehensive health benefits
• Retirement savings plan
• Paid time off (PTO)
• Education assistance
• Financial education and support, including Daily Pay
• Expanded Paid Parental Leave

Well Span Health's vision is to reimagine healthcare through the delivery of comprehensive, equitable health and wellness solutions throughout our continuum of care. As an integrated delivery system focused on leading in value-based care, we encompass more than 2,300 employed providers, 250 locations, nine award-winning hospitals, home care and a behavioral health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and one of the best in the nation.

With a team 23,000 strong, Well Span experts provide a range of services, from wellness and employer services solutions to advanced care for complex medical and behavioral conditions. Our clinically integrated network of 3,000 aligned physicians and advanced practice providers is dedicated to providing the highest quality and safety, inspiring our patients and communities to be their healthiest.

Well Span Good Samaritan Hospital For more than 125 years, Well Span Good Samaritan Hospital has provided leading-edge inpatient, outpatient, and emergent care to the Lebanon County community. One of eight premier hospitals in the Well Span system, Well Span Good Samaritan Hospital features an award-winning cardiac and vascular center, a certified Primary Stroke Center, and a wound care and hyperbaric medicine center, while providing a supportive continuum of care through our extensive Well Span primary, specialty, ambulatory, and behavioral health care locations within the community.

Well Span Good Samaritan Hospital is supported by the nearby Well Span Sechler Family Cancer Center, Lebanon's first and only integrated cancer…