Registered Nurse (RN) - Care Coordinator - Weekend Float
Core
Coordinate patient care transitions from acute hospitalization to post-discharge settings, ensuring quality, efficiency, and cost-effectiveness while managing payer reimbursement and risk management.
Role type
Senior Registered Nurse Care Coordinator
Builds
Patient discharge plans, care transition pathways, and payer reimbursement strategies
Domain
Healthcare / Acute Care / Care Management
Deliverable
client delivery
Required skills
Acute care nursing, multidisciplinary team collaboration, payer reimbursement management, discharge planning, risk management, medical necessity assessment, QIO/CMS guideline compliance
Preferred skills
Academic healthcare experience, UM/Care Coordination experience, specialty patient population experience, Master's in Nursing
Technologies
QIO guidelines, CMS guidelines
Responsibilities
Facilitate effective hospitalization transitions with attending physicians; collaborate with multidisciplinary teams to coordinate care delivery; develop complex patient transition/discharge plans with social workers; serve as liaison between hospital and community agencies; maintain compliance with QIO and CMS guidelines; assess medical necessity and assist in denial/appeals processes; participate in patient safety initiatives.
Seniority
Senior, hands-on IC