Care Coordinator

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The HVI Care Coordinator has coordination and clinical skills required for the comprehensive management of assigned. HVI patients in area of specialty. This position assists the team and coordinates involvement of other specialty teams necessary to develop a comprehensive plan for the patient, and reviews the plan of care with the other members of the clinical team, participates in patient care, organizes procedures/services, and coordinates discharge planning (as applicable). This position may participate in the education of employees, residents and medical/nursing students.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).

2. Obtain certification in Basic Life Support within 30 days of hire.

EXPERIENCE:

1. Two (2) years clinical experience in nursing.  

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Certification in area of specialty.

EXPERIENCE:

1. Nursing experience in area of specialty.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Manages comprehensive and individualized care for assigned patients and their families in seeking care at the Heart & Vascular Institute.

2. Assists team with daily rounds; consults and/or pre-procedure/evaluations.

3. Reviews and communicates results of diagnostic tests following established clinical guidelines and scope of practice.

4. Consults and communicates with clinic and hospital staff regarding abnormal findings in the evaluations of patients.

5. Performs succinct comprehensive plans of care and documents plans in medical record.

6. Participates in patient discharge by coordinating appropriate services for outpatient follow-up appointments in the clinic, if applicable. Collaborate with outreach clinic locations to coordinate local follow up when appropriate.

7. Serves as a resource for clinical staff caring for assigned patient.

8. Demonstrates expertise in caring for patients across the age continuum of their educational experience and licensure.

9. Recognizes emergency situations and initiates effective emergency care.

10. Assists with the evaluation of assigned patients and serves as a coordinator for follow up procedures and tests in the ambulatory setting. Participating in the scheduling of cases and procedures.

11. Promotes an environment that facilitates learning by responding to appropriate patient/family preferences, priorities and readiness to learn.

12. Provides educational programs to professional and paraprofessional personnel in area of expertise. Updates own knowledge base throughout the year.

13. Participates in community programs, distribution of literature, as appropriate in area of expertise.

14. Documents the plan of care, interventions and evaluations in a clear and concise manner for every patient visit in the patient’s medical record following approved hospital/compliance standards for documentation. 

15. Works collaboratively with medical and nursing staff to facilitate creative problem solving and provide professional support.

16. Participates and initiates inter-disciplinary approaches to patient care, program development and education.  Serves as a professional role model.

17. Participates and provides leadership for committees and task forces.

18. Documents hours and submits billing reports, as appropriate. 

19. Reviews data from sources such as patient registries as necessary.

20. Participates in clinical trials and research studies with the Principal Investigator (as applicable).

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Able to manually lift patients, and limit safe patient handling to 35 pounds. All transfers, lifts and re-positioning will be completed utilizing the lift equipment and/or other patient handling aids as indicated by the patient’s profile and appropriate algorithms.

2. Heavy/Hard work: Work requires strength and/or stamina, lifting, moving, stooping, reaching, standing, walking, and carrying of materials and equipment weighing 40+lbs.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Working closely with others.

2. Working protracted or irregular hours and may be required to travel to outreach clinic locations as needed.

3. Working around biohazards.

4. Working around infectious diseases.

5. Working with or near the deceased.

6. Working with hands in water.

7. Working electrical hazards associated with patient care equipment.

SKILLS AND ABILITIES:

1. Proficiency with computers.

2. Strong communication skills.

3. Ability to obtain other licensure as needed for outreach.

4. Ability to utilize equipment in a safe manner.

5. Ability to update own knowledge base throughout the year.

Additional Job Description:

This hybrid role supports heart failure education and transition of care for patients being discharged from inpatient status, while also serving as a dedicated coordinator for the Ventricular Assist Device (VAD) program. The successful candidate will work collaboratively with the Advanced Heart Failure medical team to provide clinical management, care coordination, education, and 24-hour post-discharge support for patients who are recipients of ventricular assist device.

• Review patient lists and reports to identify patients with heart failure who may benefit from targeted education, care coordination, and follow-up to support optimal disease management and outcomes.

• Provide individualized, patient-centered education to identify and address modifiable risk factors contributing to heart failure exacerbations and hospital readmissions.

• Communicate identified concerns and modifiable risk factors to the appropriate provider to facilitate timely intervention and individualized care planning.

• Participate in patient discharge planning by coordinating appropriate services for outpatient follow-up appointments in the clinic.

• Collaborate with outreach clinic locations to coordinate local follow-up when appropriate.

• Serve as a resource for clinical staff caring for assigned patients.

• Manage comprehensive and individualized care for assigned patients and their families seeking care at the Heart & Vascular Institute.

• Provide pre- and post-VAD education to patients, caregivers, hospital staff, and community members who may encounter a VAD patient.

• Create, organize, and provide initial and annual VAD training. Establish and maintain education and competency for hospital and community staff.

• Provide educational programs to professional and paraprofessional personnel in the area of expertise.

• Maintain personal VAD competencies and training per policy.

Scheduled Weekly Hours:

40

Shift:

Exempt/Non-Exempt:

United States of America (Exempt)

Company:

WVUH West Virginia University Hospitals

Cost Center:

132 WVUH HVI Admin

Address:

1 Medical Center DriveMorgantownWest Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.