This Patient Care Management Coordinator provides comprehensive care coordination of patients as assigned. The care coordinator assesses the patients plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patients health care needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care.
This position has responsibility to determine how to best accomplish functions within established procedures, consulting with leader on any unusual situations. Internal customers include all levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External customers include physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies.
This position will work in the ED with the hours being 10:00 am - 6:30 pm.
Manages patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
Acts as one point of contact for patients, physicians and care providers throughout the patients hospitalization.
Initiates/implements transition functions and activities for patients communicating with patients, families and the health care team to ensure seamless transitions.
Assesses patient admissions and continued stay utilizing evidence based criteria.
Contributes to the development and implementation of individualized patient care plans.
Collaborates with health care team partners and patients/family to manage the patient discharge plan.
Effectively communicates the plan across the continuum of care.
Assist in the development and implementation of process improvement activities to achieve optimal clinical, financial and satisfaction outcomes.
Enables efficiency in care by identifying and reducing delays, ensuring appropriate level of care, facilitating length of stay reductions and identifying resources to promote a safe and effective discharge.
Collects data and other information required by payers to fulfill utilization and regulatory requirements.
Identify and communicate, to appropriate leader, all issues related to case escalation.
Establishes a collaborative relationship with physicians, medical directors, nurses and other unit staff, and payers.
Demonstrates effective communication by being a critical link with attending and consulting physicians and all health care team members and payers. Facilitates resolution to any identified issues.
Mentors internal members of the health care team on case management and managed care concepts.
Understands and focuses on key performance indicators.
Actively tracks outcomes and participates in quality planning.
Facilitates integration of concepts into daily practice.
Organization Expectations, as applicable:
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served
Partners with patient care giver in care/decision making.
Communicates in a respectful manner.
Ensures a safe, secure environment.
Individualizes plan of care to meet patient needs.
Modifies clinical interventions based on population served.
Provides patient education based on as assessment of learning needs of patient/care giver.
Fulfills all organizational requirements
Completes all required learning relevant to the role
Complies with all relevant laws, regulation and policies
Performs other duties as assigned.
Bachelors Degree in Nursing
5 years clinical experience
1+ years working as a care coordinator/case manager
Active MN Registered Nurse license
Case Management Certification
Basic Life Support (BLS)
Additional Requirements (must be obtained or completed within a period of time) :
A person in this role must:
Have an understanding of hospital, community resources and resource/utilization management.
Have working knowledge of use of evidence based guidelines.
Demonstrate critical thinking skills, problem-solving abilities, effective communication skills and time management skills.
Demonstrate ability to work effectively on an interdisciplinary team.
Have familiarity with computer systems and Microsoft applications.
Be available/able to work flexible hours, including covering weekends, and work on call as assigned.
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership with the University of Minnesota, ...Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.