Summary: The RN Care Coordinator functions within the full scope of nursing practice to coordinate patient care across the continuum of care (inpatient/outpatient/community). Coordinates the discharge/transition plan from inpatient or ED that meets the medical, rehabilitative, and financial needs of the individual. Collaborates with the patient, family, heath team members, and community resources to ensure safe, quality, cost effective care and appropriate utilization of resources. The Care Coordinator assists patients to reach optimal function and health by establishing goals based on the patient’s needs or problems. Explores patient’s understanding and knowledge of current health status. Educates patients on medications, disease conditions and self-management skills. Uses assessment skills and risk assessment tools to identify patients with actual or potential health care needs that would require care coordination. Applies the process of assessment, planning, implementation, monitoring, evaluation, and coordination of care to meet the patient’s health care need at all levels of transition. May meet with patients face-to-face in a health care facility, practice, office, or patient home, in groups or telephonically. May be required to provide POCT (point of care testing) services for diabetes management, anticoagulation therapy, as well as medication dose regulation. RNs with appropriate education may participate in Pre-diabetes (DPP) and diabetes (DSMT/DSME) education programs utilizing established professional guidelines. RN providing instruction in the DSMT/DSME programs will also follow the “Diabetes Education RN & Instructor” job description. RNs with appropriate education may participate in management of patients on anticoagulation therapies. Willingness to cross train to all areas of care management. Requires superior communication skills, organizational skills, computer proficiency, ability to multitask and to prioritize. Must be self-motivated. Weekend rotations required.
Benefits:
MDI Hospital and Birch Bay Retirement Village offer a competitive salary, robust medical/dental/vision/life insurance, identity theft protection program, matching retirement plan, ample paid time off, a comprehensive award winning wellness program with reimbursement incentives, generous tuition reimbursement, and continuing education benefits. Some positions may qualify for a sign on bonus and relocation assistance.
EEO Statement:
MDI Hospital and Birch Bay Retirement Village provide equal employment opportunities to all employees and applicants for employment in all job classifications without regard to race, color, religion, age, mental disability, physical disability, medical condition, gender, sexual orientation, genetic information, ancestry, marital status, national origin, veteran status, and other classifications protected by applicable state and local non-discrimination laws.
Requirements
Education, Training or Certifications Required:
Current professional licensure as Registered Nurse in Maine.
AHA BLS certification.
Experience Required:
3-5 years’ experience in acute care nursing, home health or care management.
Ability to organize, prioritize and multi-task.
Strong time management skills. Self-motivated.
Computer proficiency
Ability to communicate well with team, patients, and family.
Experience managing those with chronic illness, behavior modification, goal setting, and education.
Care management experience preferred.
Special Requirements:
1. Valid Maine driver’s license and daily access to reliable and insured vehicle
2. Must have organizational skills, the ability to self-motivate, and the ability to prioritize duties
3. Proficient computer literacy including, but not limited to, electronic medical records, electronic data entry, report/data generation and retrieval. Ability to learn multiple system software. Ability to use Microsoft Word, Windows, Excel
4. Ability to use basic office equipment: phones, computers, fax machine, scanners, copiers, calculator.
5. Must be able to support the organizations mission, vision, and values
6. Ability to communicate clearly and effectively
7. Ability to maintain effective work relationships and to work collaboratively with the health care team
8. Ability to develop a collaborative therapeutic alliance with individuals
Cognitive Requirements:
1. Emotional maturity
2. Critical Thinking ability
3. Reading, writing, and mathematics
4. Ability to analyze data and reports
5. Ability to develop plans, procedures, goals, strategies or processes
6. Versatility, flexibility, and willingness to work within constantly changing priorities and health care environment
Physical Demands:
1. Able to sit, stand, walk for minimum 8-hour shifts.May occ. need to work in excess of 8 hr
shift. May require walking outside to various buildings on campus.
2. Work weekend rotations.
3. Able to carry 20 lbs.
4. Drive to practice sites, visit sites, meetings
5. Ability to sit for long periods of time. Ability to reach, bend, stoop, squat or twist repeatedly
throughout the day.
6. Prolonged time on telephone and computer.
7. Adequate hearing and vision (with or without correction). Position requires hand and finger dexterity.
Environment:
1. Potential for exposure to blood/body fluids and communicable diseases.
2. High stress potential.
3. Frequent use of VDT.
4. Work in close proximity to coworkers or other members of the health care team.