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Northwest Community Hospital Clinical Care Coordinator in Arlington Heights, Illinois

Shift: Full time, Days, Every other weekend Reporting to the Director Care Coordination, provides patient flow and outcome management services in collaboration with Northwest Community Healthcare (NCH) inter-disciplinary teams, that result in the efficient use of resources in the System of Care settings at NCH to meet the clinical care needs of patients that are aligned with the patients care plan and progression. Responsible for the initial status and ongoing continued care stay in accordance with the Center for Medicare/Medicaid Service (CMS) and commercial payer guidelines. Collaborates with the healthcare team to achieve optimal efficiency in clinical, financial, length of stay and satisfaction outcomes. Facilitates patient plans of care, implements and coordinates care progression, monitors, and assists care team in evaluating options, services and interventions to meet patient’s health care needs through effective communication, collaboration and coordination requisite to efficient clinical care progression. 1. Oversees and manages efficient patient flow for the unit by facilitating collaboration between nursing and interdisciplinary teams involved in the patient care plan including physicians, the Hub, mid-level providers, utilization management, and other ancillary and support services departments as required to identify and resolve issues that affect patient progression and the team. 2. Coordinates the advancement of assigned patient’s plan of care with patients, families, staff nurses and physicians for appropriate sequencing of care and interventions while providing oversight to ensure appropriate clinical pathways, protocols and standards of care are initiated and followed. Collaborates with physicians and, based on patient care plan and condition, recommends appropriate consults or ancillary services that advance patient progression. Works with the entire care team to ensure the patient is receiving the appropriate level of care and progressing according to plan. 3. Conducts initial and continued patient stay reviews by monitoring assigned patient’s care plan, status (inpatient, outpatient, and observations) and length of stay (LOS) targets for changes and confers with staff nurses, physicians, utilization management and clinical documentation specialists to ensure DRG assignments and length of stay targets are accurately reflected in the electronic medical record as patient conditions change. Maintains awareness of resource utilization on assigned patients and correlates to the clinical plan of care. Collaborates with utilization management, clinical documentation specialists and the HUB team to assist in managing any discrepancies in the consumption of resources related to the patients clinical, regulatory, or length of stay aspects of care. 4. Develops and implements proactive patient discharge plans upon admission in conjunction with physicians, staff nurses, utilization management, and social worker according to patient needs and payor requirements. In conjunction with the Staff Nurse and Social Worker, initiates the development of patient discharge plans for complex patients and works with the utilization management team to eliminate discharge barriers as needed. 5. Jointly leads daily ‘Status-Now-Action-Planning’ (SNAP) Huddles and participates in multi-disciplinary meetings as appropriate, and escalates any and all barriers to leadership. 6. Coordinates with leadership, unit staff, educators and support departments to ensure compliance with government and commercial payer regulations and incorporating the Utilization Review Management Policy in initial reviews and continued stay reviews. 7. Consults with utilization management and clinical documentation specialists to serve as an expert resource to unit based staff and physicians regarding patient status and placement, utilization of resources and general payer requirements. 8. Adheres to all Northwest Community Hospital standards, policies, and procedures. 1. Bachelor’s of Science in Nursingrequired. 2. Currentlicensureto practice nursing in the State of Illinois. 3.Two yearsof experience in an acute care settingrequired, specialty requirements vary by unit. 4. Previous leadership experiencerequired. 5. General knowledge of case management processes including discharge planning, health care reimbursement, utilization review process, and applicable community resources preferred. 6. Case management certification requiredorobtained within one year of eligibility. 7. Excellent verbal communication and interpersonal skills needed to work in a collaborative practice setting with an interdisciplinary team and to interact effectively with patients, physicians, payers, reviewers and other agencies. 8. Excellent skills in the following areas: critical thinking, problem identification and resolution, adoption to change and negotiating. 9. Organizational skills necessary to work independently, follow through on daily activities, multi-task and effectively manage time and resources not under their direct control. 10. Proactive and self-directed with the ability to prioritize and make decisions in a fast paced environment. 11. The analytical skills necessary to understand the relevance and impact of data and clinical information to support the appropriate utilization of resources associated with the cost and quality of patient care while keeping the focus on positive patient care outcomes. 12. Intermediate to advanced computer skills necessary to utilize multiple computer systems and software applications. PHYSICAL REQUIREMENTS: 1. Requires continuous standing and walking for most of shift. May require bending, stooping, squatting, kneeling, and overhead reaching and lifting and carrying of 15 lbs. to 30 lbs. 2. Flow of work requires concentrated mental, visual, and auditory attention most of the time. Concentrated mental, visual, and auditory attention combined with manual dexterity is required for sustained periods of time. 3. Requires visual acuity adequate to assess patients and read/record patient charts. 4. Requires auditory acuity adequate to converse with staff, speak on a telephone and receive directions from physicians and coworkers who are wearing masks. WORKING CONDITIONS: 1. Conditions are acceptable. At least one disagreeable element or hazard (i.e., infectious disease) is frequently present in the environment while several disagreeable elements or hazards are occasionally present. Must be able to work in a busy area with constant traffic of personnel Job: Nursing/Patient Care* *Title: *Clinical Care Coordinator Location: Illinois-Arlington Heights Requisition ID: 211022