Registered Nurse - Care Coordinator
No salary listed
Mid
Bachelor's, Associate's
United States
In Person
Medical, Clinical & Veterinary
About the job
Requirements
- At least one year of nursing experience in an acute care setting.
- An associate degree in nursing or a nursing diploma is required; a bachelor's degree in nursing is preferred.
- A single-state registered nurse license or a multistate compact registered nurse license is required upon hire.
- Basic Life Support certification upon hire, including an accepted listed provider or instructor credential.
- Excellent written and verbal communication skills.
- Maturity, self-confidence, objectivity, and a positive attitude.
- Ability to work independently, function under stress, handle change, and work in a fast-paced environment.
- Strong assessment, interview, organizational, and problem-solving skills.
- Knowledge of local, state, and federal regulations.
- Knowledge of community and statewide resources and programs.
- Ability to collaborate with physicians, care team members, and patients and families to support care progression through transition to the next level of care.
Responsibilities
- Assess transitional care needs and coordinate care across the continuum, engaging patients and families to ensure care needs are met.
- Plan to meet patient needs, manage length of stay, and promote efficient resource utilization through care facilitation, care progression, and transitional care planning.
- Assess psychosocial and functional status; plan transitional care; facilitate clinical care progression, patient and family conferences, interdisciplinary rounds, and patient and family education.
- Collaborate with utilization review nurses, physicians, and the interdisciplinary care team to assess medical care needs, psychosocial needs, social determinants of health, goals and outcomes, and ongoing care needs.
- Monitor patient progress toward discharge goals and help address barriers.
- Consult appropriate disciplines and departments to identify and resolve delays and expedite care and discharge.
- Assess chronic disease management needs, psychosocial risk factors, and available resources for patients after discharge based on preliminary screening.
- Partner with patient access services, financial counselors, and utilization management nurses to assess insurance and coverage requirements and support payer compliance.
- Collaborate with patients, families, physicians, and care team members to establish and support care progression and discharge plans.
- Meet routinely with physicians and the care team to coordinate timely and efficient patient management.
- Identify diagnostic or treatment delays that could delay discharge; discuss inpatient medical necessity when outpatient testing may be more appropriate; and resolve or escalate discharge barriers.
- Manage discharge planning for assigned patients, implement plans promptly, and provide resources efficiently.
- Meet with patients and families to assess needs and develop individualized discharge plans in collaboration with physicians.
- Identify and document barriers to timely disposition and maintain discharge-plan consensus among patients, families, physicians, care teams, and payers.
- Respond to referrals for post-acute needs and participate in interdisciplinary rounds to confirm estimated discharge dates and recommend the appropriate transition level of care.
- Initiate and facilitate post-acute referrals through departmental processes and refer appropriate cases for social work intervention under departmental protocols.
- Respect cultural and religious beliefs when providing service and continuity of care.
- Complete and document initial clinical and psychosocial assessments in the medical record; keep records current and documentation clear and concise.
- Document interactions with patients, families, physicians, care teams, and community partners in timely and accurate progress notes, and record services arranged or delivered in the electronic medical record.
- Track avoidable days and report trends associated with undesired outcomes.
- Complete initial and ongoing competency assessments and required mandatory and population-specific education.
- Support department goals that contribute to organizational success.
- Serve as a preceptor or mentor for student interns when appropriate.
- Perform other duties as assigned and comply with Wellstar Health System policies, standards of work, and code of conduct.
Desired Qualifications
- Experience in care coordination, discharge planning, or utilization management is preferred.
- A bachelor's degree in nursing is preferred.
About the company
Wellstar Health System provides comprehensive medical care across Georgia through hospitals, clinics, outpatient centers, a pediatric center, nursing centers, hospice and home care services, supported by nearly 30,000 team members. It operates a network that combines primary care and specialty medicine, including multiple trauma centers and a large Emergency Department; patients access care through inpatient facilities, outpatient centers, and home health, supported by an integrated care model. Wellstar differentiates itself with an inclusive culture, high-quality care, and strong workplace recognition, while being one of Georgia's largest integrated health systems with multiple trauma centers and a top emergency department. Its goal is to improve health and well-being for everyone served by compassionate care, pursuing excellence, and transforming how healthcare is delivered.
Company Size
10,001+
Company Stage
N/A
Total Funding
N/A
Headquarters
Atlanta, Georgia
Founded
1997
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Simplify's Take
What believers are saying
- Stephens County Hospital deal announced September 2, 2026 expands reach to 14 hospitals.
- Columbia County Medical Center started seeing patients August 26, adding 100 beds in Grovetown.
- Curative named Wellstar cornerstone network partner August 21, broadening employer-driven patient volume.
What critics are saying
- Wellstar cut 761 corporate jobs on July 28, 2026, signaling execution strain.
- Stephens County approval can stall until late 2026, delaying synergies and distracting leadership.
- One bad patient-safety event at new hospitals would damage Georgia referrals and regulator trust.
What makes Wellstar unique
- Wellstar runs 12 hospitals after Mountain Lakes closed August 10, 2026.
- Columbia County Medical Center opened August 26, 2026 with six ORs and ICU-convertible rooms.
- Wellstar anchors Georgia access through tele-stroke, specialist networks, and Curative's 400-plus locations.
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Benefits
- Flexible Work Hours
- Professional Development Budget
- Conference Attendance Budget