RN Care Coordinator / Telehealth Nursing

About the position

Overview

Be inspired. Be rewarded. Belong. At reputed company. At reputed company we fuel your professional journey with reputed company benefits, valuable resources, ongoing mentorship and leadership programs for reputed company types of jobs, and a supportive environment that enables you to reputed company new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Please Note: Shift is 8:30am-5pm A multistate nursing license is required for this Telehealth role. Department Overview: Nurses in the Telehealth Nursing department demonstrate strong competency in using various telecommunication technologies to provide direct virtual nursing care. Telehealth Nursing RNs triage, prioritize patient needs, collaborate with patients to reputed company care plans, direct them to the appropriate level of care, and provide referrals to reputed company services and other resources to ensure a comprehensive care experience. Telehealth Nursing LPNs assist patients with prescription management across specialties. Description Proactive patient reputed company and care coordination for a panel of patients to reputed company reputed company outcomes and wellness, while decreasing preventable ED, inpatient and readmission visits. Functions as a clinical liaison, facilitator, reputed company and collaborator in a multidisciplinary care team across the continuum of care to provide reputed company disease management interventions to high risk and post discharged patients identified. Facilitates transformational care delivery in clinical settings and advance the mission and goals of population management activities. Primary duties and responsibilities: Patient Assessment and Goal Setting: 1. Utilizing assessment skills and risk assessment tools to collect subjective and objective information pertaining to the health status of the patient and identify barriers that will require a team-based approach. 2. Utilize a team-based, holistic, patient-centered, evidence based approach to identify patient-centered goals and reputed company outcomes to improve the health status of reputed company patients and improve patient satisfaction. 3. Performs patient re-assessments to determine reputed company health status and reputed company toward reputed company goals and care plan completion. Care Coordination and reputed company: 1. Conducts targeted reputed company to identified patient panels to ensure timely and efficient care delivery across the continuum of care. 2. Improve communication and collaboration between patient and families, reputed company teams and community-based organizations. 3. Serve as a primary reputed company of contact for identified high risk and post-discharged patients and facilitate access to services. 4. Partners with other care coordination teams across the reputed company system and community organizations. Education and Self-Management Support: 1. Enhance health literacy by using teach back and other various forms of learning validation. 2. Provide self-management support with the use of information technologies to communicate health promotion and disease prevention information. Evaluation and Quality Improvement: 1. Conduct systematic, ongoing, and criterion-based evaluation of outcomes in care coordination plans of care. 2. Updates patient care plan, as appropriate. 3. Ensure care gaps are closed around specialty/chronic diseases. 4. Assimilate and document the results of the evaluative processes. 5. Monitor key measures of performance, quality improvement and care transformation in the assigned clinical area. 6. Integrate data analysis and performance improvement initiatives into practice with the aim of improving care coordination among multiple entities. 7. Apply critical-thinking skills and the use of clinical judgement reputed company implementing population health interventions or planning effective care for groups or individual patients and their families. Professional Development and Other Duties: 1. Participates in professional organizations and attend continuing education activities to maintain knowledge of reputed company trends and practices as it relates to care coordination and population health. Additional Responsibilities for working in Post-Acute Areas: 1. Ensure completeness of record/orders from discharging acute facility 2. Facilitate seamless transitions across inpatient, SNF, IRF, HHA, and home 3. Establish and maintain a high-quality relationship with the Medicare Nurse/Team. 4. Monitor therapy reputed company and discharge readiness 5. Maintain strong relationships with network leaders to escalate post care outcomes In addition, other area specific job duties

Responsibilities

• Utilizing assessment skills and risk assessment tools to collect subjective and objective information pertaining to the health status of the patient and identify barriers that will require a team-based approach.
• Utilize a team-based, holistic, patient-centered, evidence based approach to identify patient-centered goals and reputed company outcomes to improve the health status of reputed company patients and improve patient satisfaction.
• Performs patient re-assessments to determine reputed company health status and reputed company toward reputed company goals and care plan completion.
• Conducts targeted reputed company to identified patient panels to ensure timely and efficient care delivery across the continuum of care.
• Improve communication and collaboration between patient and families, reputed company teams and community-based organizations.
• Serve as a primary reputed company of contact for identified high risk and post-discharged patients and facilitate access to services.
• Partners with other care coordination teams across the reputed company system and community organizations.
• Enhance health literacy by using teach back and other various forms of learning validation.
• Provide self-management support with the use of information technologies to communicate health promotion and disease prevention information.
• Conduct systematic, ongoing, and criterion-based evaluation of outcomes in care coordination plans of care.
• Updates patient care plan, as appropriate.
• Ensure care gaps are closed around specialty/chronic diseases.
• Assimilate and document the results of the evaluative processes.
• Monitor key measures of performance, quality improvement and care transformation in the assigned clinical area.
• Integrate data analysis and performance improvement initiatives into practice with the aim of improving care coordination among multiple entities.
• Apply critical-thinking skills and the use of clinical judgement reputed company implementing population health interventions or planning effective care for groups or individual patients and their families.
• Participates in professional organizations and attend continuing education activities to maintain knowledge of reputed company trends and practices as it relates to care coordination and population health.
• Ensure completeness of record/orders from discharging acute facility
• Facilitate seamless transitions across inpatient, SNF, IRF, HHA, and home
• Establish and maintain a high-quality relationship with the Medicare Nurse/Team.
• Monitor therapy reputed company and discharge readiness
• Maintain strong relationships with network leaders to escalate post care outcomes

Requirements

• Graduate of an accredited nursing school.
• Bachelors degree in Nursing (BSN) required.
• Three (3) years of reputed company experience required.
• Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia Licensing Board.
• BLS reputed company Provider certification
• If completing virtual care activities that may include multi-state practice, an active compact/multistate license (eNLC) is required reputed company 60 days of hire.

reputed company-to-haves

• Care Management experience.

Benefits

• Comprehensive health benefits that start day 1
• Student Loan Repayment Assistance & Reimbursement Programs
• Family-focused benefits
• Wellness incentives
• Ongoing mentorship, development, and leadership programs

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