VCU Health System's Care Coordination is seeking a full time RN Care Coordinator to function as a part of a multidisciplinary team, including physicians, social workers, discharge planning assistants and payers. Ensures that patient's progress in the acute episode of care through post discharge is quality driven while being efficient, cost effective and safe. Will also be patient focused and outcome oriented.
Works with the attending and consulting physicians to facilitate effective and efficient transition through the process of hospitalization. Works collaboratively with all members of the multi-disciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum, as well as appropriately reimbursed by payers as contracted, and that resources are efficiently and effectively utilized.
Seeks the expertise of social workers to resolve psychosocial patient care issues and to develop complex patient transition/discharge plans as needed. Interacts with patients, family members, healthcare professionals, and community and state agencies in this effort. Serves as an advanced clinical resource to the team.
Serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information. The role is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) series and CMS guidelines.
Utilizes medical necessity criteria as a tool to assess appropriateness of level and setting of care, assists in the denial and appeals process, assesses quality and identifies and reports potential risk management issues.
Responsible for participation in and completion of all patient safety initiatives appropriate to the position. The incumbent conducts all job responsibilities according to VCUHS' Mission and Values. Responsible for establishing and maintaining a professional rapport with providers, patients/families, and internal customers.
Licensed Registered Nurse in the State of Virginia or eligible
Baccalaureate Degree in Nursing from an accredited School of Nursing
Minimum of three (3) years of nursing experience in an acute care setting
Master's Degree in Nursing or a healthcare related field from an accredited program
Academic healthcare experience
One (1) year of UM/Care Coordination experience
Clinical experience with specialty patient population
At VCU Health System, our most important assets are not bricks and mortar; they are our team members … all 12,000+ of them. Our workforce is diverse, dedicated and talented. Our team members continue to earn local, regional and national awards and accolades, which is an indicator that they are happy and feel supported working here. And our culture of STAR Service focuses on our common purpose – “Our Caring Service Begins With Me.” – in the provision of the highest level of customer service, which encourages diversity and inclusion.
If you have been looking to take your career to the next level, we have been looking for you. We offer more than 400 work/life benefits including competitive pay, generous benefits, flexible work options, prepaid tuition, on-site child and elder care and much, much more.
Every day, there’s a new discovery at VCU Medical Center.
Whether it’s a patient who undergoes a new, life-saving procedure or a clinical researcher who finds promise in a new cancer treatment, exciting medical advances are taking place.
As the only academic medical center in central Virginia, VCU Medical Center is on the forefront of health care, providing patients with the most progressive treatments and medical technology available.