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Enloe Health

Regional hospital and health services

Care Coordinator - RN, Case Management

Full-Time
$58.56 - $79.06
Mid
Bachelor's, Master's
Chico, CA, USA
In Person
Medical, Clinical & Veterinary

About the job

Requirements
  • Two years of acute care clinical experience, one year of recent case management experience in an acute or post-acute setting, or a Master's in Nursing with a Case Management emphasis is required.
  • Current licensure with the California Board of Registered Nursing is required.
  • Current CPR recognition is required.
  • The role requires assessment, planning, intervention, and evaluation of patient care.
  • Current clinical nursing knowledge must be demonstrated through completion of the staff nurse OCAT and passing the medication administration examination.
  • Clinical nursing knowledge must be maintained through annual completion of the Skills Fair.
  • Understanding of third-party reimbursement methodologies is required.
  • Critical thinking and analytical skills are required.
  • The role requires maintaining strict confidentiality of patient information.
  • The role requires building positive working relationships with physicians and external agencies.
  • The role requires communicating with multiple organizational levels, including managers, physicians, clinical staff, and support staff.
  • The role requires the ability to use Microsoft Word, Excel, Outlook, Midas, Chart Max, and Epic computer systems.
  • Organizational and multitasking skills are essential.
  • The employee must be able to fulfill the essential functions of the position.
Responsibilities
  • Coordinate care and services for assigned patients throughout an episode of illness or treatment, in collaboration with the patient, family, physician, patient care team, and payors.
  • Use advanced clinical skills and nursing-process principles to assess, plan, intervene, and evaluate care.
  • Promote and evaluate effective resource utilization using current clinical knowledge and awareness of community services.
  • Assume a leadership role with the patient care team to achieve optimal clinical and resource outcomes.
  • Evaluate and analyze quality and utilization cases, admission and discharge criteria, observation and one-day stays, readmissions within 30 days, Medicare criteria, and diagnosis-related criteria.
  • Participate in ongoing outlier review.
  • When assigned to the Emergency Department, collaborate with the patient and family, multidisciplinary team, physicians, and payors to support efficient, cost-effective progress through the emergency episode of care.
  • Advocate for patients and families throughout the episode of care.
  • Remain available as a resource to patients and families, facilitate communication among providers, and monitor services rendered.
  • Remain involved until the patient is discharged or appropriately transferred to acute care or an alternate level of care.
  • Initiate appropriate clinical pathways based on admission diagnosis and serve as a resource for utilization management purposes.
  • Maintain confidentiality of patient information, collaborate, and delegate when appropriate.
  • Assume fiscal responsibilities.
Desired Qualifications
  • A bachelor's degree in nursing is desired.
  • Experience in acute clinical case management and utilization review is desired.
  • Working knowledge of managed care requirements and hospital information systems is desired.
  • Experience in the assigned area is preferred.

About the company

Enloe Health is a nonprofit health system centered on Enloe Medical Center in Chico, California. It provides emergency, surgical, cancer, heart, maternity, rehabilitation, home-health, and outpatient care. Hospital and community locations serve patients across the North State region. Enloe functions as a regional care hub, with a workforce spanning bedside medicine, specialty clinics, diagnostics, allied health, patient support, facilities, technology, home-based care, and the administrative systems behind service delivery.

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