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Form of workPosition Summary
The Clinical Care Coordinator is a professional member of the health care team who assumes advocacy and accountability and works in collaboration and continuous partnership with chronically ill or high-risk patients and their family/caregiver(s), clinic/hospital/specialty providers and staff, and community resources in a team approach to provide a continuity of the single standard of care.
Duties & Responsibilities
Performs independently in coordinating and tracking patient care, and providing discharge planning for patients. Provides discharge /educational instruction for patients/families. Collaborates with appropriate resources in implementing educational programs. The CCC participates in the development of the plan of inpatient care, according to patient specific age and/or developmental needs. In collaboration with the multidisciplinary health care team, the CCC utilizes clinical pathways in support of the provision of care. The CCC collaborates with other health care team members and with external payer sources in the delivery and coordination of care during a single episode of hospitalization through discharge to home or to next level of care. Also responsible for tracking of quality measures related to care coordination efforts. Screens patient records, as assigned, using specific criteria and critical judgment, in order to identify adverse events, sub-optimal patterns or care and or utilization. Reviews pertinent documentation, interprets clinical data; identifies variations in care and or utilization based on knowledge of disease processes and appropriate treatment modalities, relevant data. Analyzes data which has been collected, evaluates current practice, draws conclusions and makes recommendations for changes or improvement as appropriate and monitors the status of resolution of identified issues. Reports adverse event, as appropriate, summarizes findings and maintains accurate records of all reviews performed. Includes review of incident reports, complication reports from all departments, patient satisfaction survey comments, mortality reports. Coordinates physician peer review committees (Special Medicine, Surgical, Psychiatric, anesthesia and Obstetrics Committee) and prepares and/or presents information to appropriate committees, forums, as requested. Collaborates with medical staff to review and interpret medical staff monitoring activities relative to the quality and appropriateness of patient care, the utilization of resources, and collaborates with Risk Management, as appropriate. Works closely with JMH Clinical Performance Specialist and other JMH staff who are responsible for maintenance, review and updating of the Nursing Standards Manual and Red Book Policies. Coordinates review of those policies and procedures that are being addressed at General and Critical Care Policies and Procedures (P&P) committees with the appropriate departments/management staff and obtains appropriate feedback/recommendations. Facilitates completion and update policies and procedures that are not integrated with assigned facility. Ensures final integrated policy and procedures/forms are placed in the current computer system file and the old P&P is archived. The index is updated to direct staff where to find P&P and forms. Facilitates monthly unit educators meeting to provide policy/forms and updates. Ensures hospital-wide Red Book manuals are updated with new revisions. Participates in hospital-wide quality improvement activities. Maintains knowledge of JCAHO standards and assists with preparation for JCAHO survey. Conducts record review audits and unit inspections to assess JCAHO readiness compliance. Participates in community seminars and continuing education programs in order to enhance own knowledge base and to exchange appropriate information with peers. For CCC working as Observation Liaison: assess complex patient care needs/situation/acuity levels obtaining significant date from assessments (physical/function, mental, psycosocial, environmental, family support, spiritual, cultural, financial, legal). Coordinates patient care through out an episodic / continuous course of care for a specific DRG/diagnosis/procedure/population using InterQual, Millikan or other specific criteria and evidence based guidelines. Completes electronic documentation for case management activities such as discharge planning, patient throughput, appropriate level of care, communication with physician, nursing and patient / family member. Articulates information pertinent to clinical condition, LOS, discharge delays, outcomes, resource utilization, discharge planning, etc. at the team meetings / presentations, patient care rounds, interdisciplinary rounds and to administration, medical director and physician advisors. Demonstrates effective interpersonal communication skills through the development and maintenance of productive working relationships with medical staff, nursing, ancillary departments, administrative staff and peers. Follows and performs all related unit specific policies and procedures, as detailed on the unit specific competency check-list. Utilizes job and unit specific equipment as required. Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs all other related job duties as assigned.
Qualifications
Education
BSN or Bachelor's degree in related field is required. Master's degree is preferred.
Experience
Generally requires 3 to 5 years of related experience.
License/Certification
Valid Florida RN license is required. American Heart Association Basic Life Support (BLS) and any additional applicable life support certification for Healthcare Providers is required upon hire with at least 6 months validity and maintenance at JHS for the duration of employment. Must meet and maintain valid and current all unit specific and organizational skills/competencies, certifications/licensures, as required by regulatory and/or nursing standard of practice for the specialty.
Knowledge/Skill/Abilities
General Competencies: Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications. Nursing Competencies: Ability to understand, respects and accommodates patients preferences and needs with regards to their individual beliefs, customs and practices. Must have ability to clearly, accurately and effectively provide information to doctors, other nurses, patients, and family members. Must have ability to show compassion, patience and maintain non-judgmental approach to patients, their families as well as other employees and customers. Unit Specific Competencies: Must have clinical knowledge, skill and ability to fully and accurately complete all required unit competencies, as indicated in the unit competency check-list.
Physical Demands
Job function requires extended standing or walking. Must be able to carry objects weighing 21 to 50 pounds. Able to lift or move objects weighing 51 to 100 pounds with the use of appropriate devices. Jobs in this group require frequent visual acuity to perform activities related to extended use of computers. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
Work Environment
Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Exposure to various environments such as: communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May also be exposed to needle sticks, airborne infections, medical gases, X-Ray, chemical exposures and other potential hazards. Must wear Personal Protective Equipment (PPE) when exposed to infectious/clinical hospital environment. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
The Clinical Care Coordinator is a professional member of the health care team who assumes advocacy and accountability and works in collaboration and continuous partnership with chronically ill or high-risk patients and their family/caregiver(s), clinic/hospital/specialty providers and staff, and community resources in a team approach to provide a continuity of the single standard of care.
Duties & Responsibilities
Performs independently in coordinating and tracking patient care, and providing discharge planning for patients. Provides discharge /educational instruction for patients/families. Collaborates with appropriate resources in implementing educational programs. The CCC participates in the development of the plan of inpatient care, according to patient specific age and/or developmental needs. In collaboration with the multidisciplinary health care team, the CCC utilizes clinical pathways in support of the provision of care. The CCC collaborates with other health care team members and with external payer sources in the delivery and coordination of care during a single episode of hospitalization through discharge to home or to next level of care. Also responsible for tracking of quality measures related to care coordination efforts. Screens patient records, as assigned, using specific criteria and critical judgment, in order to identify adverse events, sub-optimal patterns or care and or utilization. Reviews pertinent documentation, interprets clinical data; identifies variations in care and or utilization based on knowledge of disease processes and appropriate treatment modalities, relevant data. Analyzes data which has been collected, evaluates current practice, draws conclusions and makes recommendations for changes or improvement as appropriate and monitors the status of resolution of identified issues. Reports adverse event, as appropriate, summarizes findings and maintains accurate records of all reviews performed. Includes review of incident reports, complication reports from all departments, patient satisfaction survey comments, mortality reports. Coordinates physician peer review committees (Special Medicine, Surgical, Psychiatric, anesthesia and Obstetrics Committee) and prepares and/or presents information to appropriate committees, forums, as requested. Collaborates with medical staff to review and interpret medical staff monitoring activities relative to the quality and appropriateness of patient care, the utilization of resources, and collaborates with Risk Management, as appropriate. Works closely with JMH Clinical Performance Specialist and other JMH staff who are responsible for maintenance, review and updating of the Nursing Standards Manual and Red Book Policies. Coordinates review of those policies and procedures that are being addressed at General and Critical Care Policies and Procedures (P&P) committees with the appropriate departments/management staff and obtains appropriate feedback/recommendations. Facilitates completion and update policies and procedures that are not integrated with assigned facility. Ensures final integrated policy and procedures/forms are placed in the current computer system file and the old P&P is archived. The index is updated to direct staff where to find P&P and forms. Facilitates monthly unit educators meeting to provide policy/forms and updates. Ensures hospital-wide Red Book manuals are updated with new revisions. Participates in hospital-wide quality improvement activities. Maintains knowledge of JCAHO standards and assists with preparation for JCAHO survey. Conducts record review audits and unit inspections to assess JCAHO readiness compliance. Participates in community seminars and continuing education programs in order to enhance own knowledge base and to exchange appropriate information with peers. For CCC working as Observation Liaison: assess complex patient care needs/situation/acuity levels obtaining significant date from assessments (physical/function, mental, psycosocial, environmental, family support, spiritual, cultural, financial, legal). Coordinates patient care through out an episodic / continuous course of care for a specific DRG/diagnosis/procedure/population using InterQual, Millikan or other specific criteria and evidence based guidelines. Completes electronic documentation for case management activities such as discharge planning, patient throughput, appropriate level of care, communication with physician, nursing and patient / family member. Articulates information pertinent to clinical condition, LOS, discharge delays, outcomes, resource utilization, discharge planning, etc. at the team meetings / presentations, patient care rounds, interdisciplinary rounds and to administration, medical director and physician advisors. Demonstrates effective interpersonal communication skills through the development and maintenance of productive working relationships with medical staff, nursing, ancillary departments, administrative staff and peers. Follows and performs all related unit specific policies and procedures, as detailed on the unit specific competency check-list. Utilizes job and unit specific equipment as required. Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs all other related job duties as assigned.
Qualifications
Education
BSN or Bachelor's degree in related field is required. Master's degree is preferred.
Experience
Generally requires 3 to 5 years of related experience.
License/Certification
Valid Florida RN license is required. American Heart Association Basic Life Support (BLS) and any additional applicable life support certification for Healthcare Providers is required upon hire with at least 6 months validity and maintenance at JHS for the duration of employment. Must meet and maintain valid and current all unit specific and organizational skills/competencies, certifications/licensures, as required by regulatory and/or nursing standard of practice for the specialty.
Knowledge/Skill/Abilities
General Competencies: Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with professional composure. Ability to understand and follow instructions. Ability to exercise sound and independent judgment. Knowledge and skill in use of job appropriate technology and software applications. Nursing Competencies: Ability to understand, respects and accommodates patients preferences and needs with regards to their individual beliefs, customs and practices. Must have ability to clearly, accurately and effectively provide information to doctors, other nurses, patients, and family members. Must have ability to show compassion, patience and maintain non-judgmental approach to patients, their families as well as other employees and customers. Unit Specific Competencies: Must have clinical knowledge, skill and ability to fully and accurately complete all required unit competencies, as indicated in the unit competency check-list.
Physical Demands
Job function requires extended standing or walking. Must be able to carry objects weighing 21 to 50 pounds. Able to lift or move objects weighing 51 to 100 pounds with the use of appropriate devices. Jobs in this group require frequent visual acuity to perform activities related to extended use of computers. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
Work Environment
Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Exposure to various environments such as: communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May also be exposed to needle sticks, airborne infections, medical gases, X-Ray, chemical exposures and other potential hazards. Must wear Personal Protective Equipment (PPE) when exposed to infectious/clinical hospital environment. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
