Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.
The RN Care Coordinator is an integral part of Dignity Health Care Coordination team. The Care Coordination program improves the quality of care and clinical outcomes for members with complex care needs by coordinating care within the health care delivery system using a collaborative partnership approach.
The RN Care Coordinator coordinates care and collaborates with multiple disciplinary team members across the continuum of care. Through assessments to determine unmet needs and development of the individual's care plan, the RN Care Coordinator evaluates and identifies knowledge gaps of disease process and treatments, determines appropriate resources or services required to meet an individual's health needs, provides education/coaching on disease self management for health promotion and maintenance, monitors patient's progress, promotes quality cost effective outcomes with the goal of improved care coordination amongst providers and increased involvement of the individual, family, and/or caregiver in the decision making process to reduce hospitalizations, readmissions and ER visits.
This position will involve telephonic case management and direct patient contact through follow up at clinic appointments and/or home visits as needed. Travel may be required with telecommuting option.
Two (2) years clinical experience as a RN in acute, ambulatory care, home health, skilled nursing facility, medical group or health plan setting required. A Masters Degree in nursing with a concentration in Case Management can serve as a substitute for the experience requirement.
Current CA Registered Nurse (R.N.) license.
Excellent customer service and presentation skills are a must
Strong interpersonal and written communication skills are essential
Demonstrated ability to apply analytical and problem solving skills
Ability to demonstrate leadership skills to delegate and provide direction/guidance to multidisciplinary team.
Demonstrated ability to manage multiple tasks or projects effectively
Ability to work independently as needed with a high degree of detail orientation.
Ability to work efficiently in a fast-paced environment with changing priorities.
Knowledge of regulatory and accreditation standards (URAC, NCQA) and complex case management (CMSA).
Knowledge of community resources.
Knowledge of capitation/HMO, insurance payers and government healthcare plans and audits.
Prior Care Coordination experience in a clinical or insurance setting is required. If operational conditions permit, training a candidate without the required experience may be considered.
BSN degree or experience equivalent preferred.
Case Management (CM) certification preferred.