Care Coordination RN

This role is for a Care Coordinator RN responsible for assessing patients' transitional care needs, coordinating care across the continuum, and engaging with patients and families to ensure care goals are met.

Key duties include conducting psychosocial and functional assessments, developing individualized discharge plans, facilitating interdisciplinary rounds, and managing discharge processes to promote timely transitions.

The RN collaborates with physicians, care teams, social workers, and payers to assess medical, psychosocial, and social needs, addressing barriers to discharge and ensuring appropriate resource utilization.

Responsibilities also involve documenting assessments and care plans accurately, proactively identifying delays, and resolving obstacles to expedite patient discharge.

Qualifications include a minimum of 1 year of acute care nursing experience, an RN license (single state or multi-state), and certifications such as BLS.

Essential skills comprise excellent communication, organizational, problem-solving abilities, and knowledge of healthcare regulations and community resources.

Ideal candidates are self-directed, able to handle stress, and work collaboratively with multidisciplinary teams to facilitate smooth patient transitions.