Care Coordination RN - Oncology
(Salaried Nursing Position - Home visits required)
Shift & Schedule: Monday - Friday 8:00 am - 5:00 pm
The care coordinator (RN) identifies and provides case management to pediatric patients who are high risk and have complex psychosocial and medical needs. By leading an interdisciplinary team, the care coordinator (RN) improves health outcomes and increases patient satisfaction through comprehensive assessment and proactive goal setting. The care coordinator (RN) must be an innovative and flexible problem solver who uses a collaborative approach. Ongoing monitoring and follow-up is provided through regular communication with patient, family and providers through attendance at scheduled appointments, participation in community meetings, home visiting and/or frequent telephone contact. Care Coordinator (RN) is expected to have in-depth knowledge of medication management, pathophysiology, evidence based practice, and prevention. Case Management and/or Pediatric Clinical Experience required.
PRINCIPAL DUTIES AND RESPONSIBILITIES
The RN care coordinator implements and supports the philosophy, mission, values, standards, policies and procedures of Children’s Hospital and the Patient Care Services Division.
1. The RN care Coordinator performs care coordination core functions which include:
a. Screening, identification and stratification of patients referred for services
b. Comprehensive assessment of patients diagnosis, medical care, history, barriers, resources, risks, current concerns and health status
c. Development of a family-centered plan of care and effective interventions to address gaps in care based on needs identified in assessment
d. Monitoring and evaluation of progress
e. Facilitation of transitions between settings and caregivers
f. Ensuring the delivery of preventive services, health promotion activities and other interventions that proactively address potential risks
g. Establishing and maintaining collaboration between primary care, specialists, community agencies, and payers to address patient needs including facilitating care conferences
2. Serves as a single point of contact for patient and multidisciplinary team
3. Assists in the acquisition or verification of financial/payer/insurance information when appropriate
4. Manages communication and assists with troubleshooting between visits and hospitalizations which may include telephone contact, home visiting, community meetings and attendance at school and/or medical appointments.
5. Facilitates the patient/family/guardian’s ability to assume responsibility for managing their health care when appropriate by:
a. Promotes return of the patient/family to the highest level of wellness possible
b. Assesses readiness for change and adjusts interventions accordingly
c. Develops patient and caregiver knowledge, skills and abilities to manage their healthcare
6. Serves as a patient/family advocate in meeting patient or family needs.
7. Serves as a resource and liaison between Nationwide Children’s Hospital and the community regarding health care information.
8. Facilitates and coordinates quality patient care in a timely and cost-effective manner
9. Coordinates and mobilizes health care and community resources to meet the needs of patients and their families through referral, consultation, and education
10. Plans, provides, delegates, and evaluates ongoing educational needs of patients/families in collaboration with members of the health care team.
11. Delegates and supervises appropriate tasks to unlicensed and administrative support staff.
12. Actively participates in clinical practice and program development, policy and procedure development, continuing education, continuous quality improvement, research and/or evidenced based practice.
13. Completes full Medication Reconciliation on assessment, face to face visits, during transitions and as needed
14. Establishes a therapeutic relationship with patient/family
15. Participates in the evaluation of peers for recognition and development.
16. Collaborates with program leaders to establish and/or maintain program goals and program budget as appropriate. Provides care in a fiscally responsible manner.
17. Actively pursues education and knowledge related to the nursing profession and their area of expertise.
18. Maintains awareness of research affecting patient populations in their specialty area. Evaluates and implements evidenced based practice as appropriate.
19. Participates in orientation and continuing education of practitioners, staff and students as appropriate. Mentors clinical staff to foster their personal and professional growth.
20. Participates in ongoing education related to information technology requirements for the department needed to perform job functions.
21. Maintains accurate documentation in the medical record of assessments, patient plans, interventions and patient response to intervention, and education provided to patients/families.
22. Supports and advances nursing practice through one or more of the following:
a. Participates as a conference speaker/presenter
b. Presents to community groups
c. Participates in professional organizations and activities
d. Participates on committees, task forces and advisory boards (department, hospital, community)
e. Participates on appropriate quality teams
f. Participates in scholarly activities
g. Publishes in journals, newsletters
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
1. Current licensure as a registered nurse in the State of Ohio required.
2. BSN required.
3. Clinical skill and knowledge in the nursing care of children including normal growth and development and/or clinical expertise in specialized area required.
4. Three years related clinical experience in area of specialty desirable. Pediatric experience preferred.
5. Effective customer service, communication, and interpersonal skills required.
6. Demonstrated leadership and teaching abilities required.
7. Professionally appropriate analytical and organizational skills required.
8. Active BLS certification.
9. Case management certification preferred.
MINIMUM PHYSICAL REQUIREMENTS
Must be able to see, speak, read and perform manual tasks with or without accommodation, and care for oneself with little or no difficulty. Performance of principal duties and responsibilities may require ability to travel.
The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individual so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision.