RN, Care Coordinator Resume Samples

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D Kris

Dominique

Kris

440 Dion Valleys

Philadelphia

+1 (555) 327 0442

440 Dion Valleys

Philadelphia

Phone

p +1 (555) 327 0442

Experience Experience

Phoenix, AZ

RN, Care Coordinator

Phoenix, AZ

Beier, Auer and Barton

Phoenix, AZ

RN, Care Coordinator

Phone and/or face-to-face support on setting up and using care coordination tools or equipment placed in the patient's home
Manage patients in current disease management programs, completing and revising as necessary, the information in care coordination documentation system
Conduct daily tracking of caseload as assigned
Adapt to a fluid, dynamic and rapidly changing environment
Maintains accurate records of case management activities in the Enterprise Medical Management Automation (EMMA) System using clinical guidelines
Develops and monitors members plan of care, to include progress toward meeting established goals and self-management activities
Review evidence that discharge planning began at admission or start of services

Detroit, MI

Icmp RN Care Coordinator

Detroit, MI

Barrows Inc

Detroit, MI

Icmp RN Care Coordinator

Established by BWH/Partners
Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as
Consults with patients’ physicians and / or Medical Directors about high priority patients and potential care management plans
Willingness to be flexible in situations. Performs duties of lesser, equal, or greater responsibility as requested
Performs all duties in an independent, professional manner and requests assistance when necessary
Demonstrates initiative and creativity to continuously improve services, processes, and other activities that affect quality and utilization
Works effectively with team members

present

Houston, TX

Icmp RN Care Coordinator Float

Houston, TX

Schmidt-Lesch

present

Houston, TX

Icmp RN Care Coordinator Float

present

Keeps current with related trends in care management, including health education and coaching
Demonstrates a positive attitude in dealing with problems or crisis situations
Exemplifies program teachings and acts as a role model for patients by practicing behaviors consistent with goals of the program
Notifies Nursing Director, PCP, MD Advocate, and/or Medical Director about (over/under) utilization of services and patient’s compliance with program
Collaborates with PCP, MD Advocate, and/or Medical Director, re., challenging patient situations
Utilizes care management systems to document, monitor, and evaluate patient interventions and care plans
Establishes a consistent communication and reporting schedule for periodic contact with providers and patients to review patient status and progress toward goals

Education Education

Bachelor’s Degree in Detail Orientation

University of Memphis

Bachelor’s Degree in Detail Orientation

Skills Skills

Problem solving skills with the ability to look for root causes and implementable, workable solutions
Professional verbal and written communication skills, with the ability to clearly articulate thoughts and ideas
Ability to create, review and interpret treatment plans Ability to create, review and interpret treatment plans
Ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
Ability to effectively present information and respond to questions from families, members, and providers
Time management skills with the ability to prioritize and schedule daily activities for the most efficient use of time
Organizational skills with the ability to handle multiple tasks and/or projects at one time
Ability to understands the business and financial aspect of case mgmt in a managed care setting
Ability to implement process improvements
Ability to multi-task Bilingual skills

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15 RN, Care Coordinator resume templates

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Icmp RN Care Coordinator Float Resume Examples & Samples

Consults with patients’ physicians and / or Medical Directors about high priority patients and potential care management plans
Influences utilization of health care resources by providing direct care coordination to patients, encouraging enrollment in disease and case management programs, providing care coordination intervention and follow-up prior to and after interaction with health care system, e.g., inpatient, ED visit, outpatient services, etc…
Using medical management criteria or other diagnostic screening criteria, determines appropriateness of hospital admissions and disease management programs. As indicated, provides direct and ongoing care management to select patients and / or refers to existing care management programs: insurance-based specialty case management programs, BWPO Disease Management programs, Partners HealthCare Disease Management programs, etc…
Communicates with other health care clinicians throughout the continuum about patient’s care, utilization, and follow up plans, e.g., ED Care Facilitators, inpatient Care Coordinators, post acute case managers, social workers, pharmacists, etc…
Notifies Nursing Director, PCP, MD Advocate, and/or Medical Director about (over/under) utilization of services and patient’s compliance with program
Collaborates with PCP, MD Advocate, and/or Medical Director, re., challenging patient situations
Acts as clinical resource person for program’s quality efforts
Attends and presents case reviews at practice meetings, program meetings, and care coordination meetings
Utilizes care management systems to document, monitor, and evaluate patient interventions and care plans
Keeps current with related trends in care management, including health education and coaching
Participates in regular meetings with the Nursing Director and Medical Director to review performance, patient volume, projects, outside professional activities, and upcoming goals to achieve
Performs all duties in an independent, professional manner and requests assistance when necessary
Work reflects excellent organizational skills
Assumes accountability for professional growth and development
Exemplifies program teachings and acts as a role model for patients by practicing behaviors consistent with goals of the program
Complies with appropriate BWH and Partners policies and procedures
Three to five years of acute care experience in a hospital setting
Three to five years of academic case management experience
Excellent oral, written, and telephonic skills and abilities
Competent using Microsoft word, powerpoint, and excel
Ability to work well with physicians and ambulatory staff in a practice or health center setting
Demonstrated ability to present and speak in front of groups
Knowledge and skills to differentiate levels of care

Field Based RN Care Coordinator Resume Examples & Samples

Facilitates appropriate member referrals to special programs such as Behavioral Health, Advanced Illness and Social Services
Documents all care coordination activities and interventions in the member’s health plan clinical record
Current, unrestricted RN license in the State

Icmp RN Care Coordinator Resume Examples & Samples

Performs program specific patient outreach, education, and recruitment
Initiates telephone or in person contact with eligible patients to perform initial assessment, healthcare education, and develop a realistic care management plan
Incorporates knowledge of case management, levels of care, and utilization management principles to implement high quality cost effective care plans
Utilizes excellent interpersonal skills when communicating with patients, families, and physicians in order to develop rapport, build trust, and engage patients in health promotion activities
Establishes a consistent communication and reporting schedule for periodic contact with providers and patients to review patient status and progress toward goals
The Ambulatory-based RN Care Coordinator (RNCC) is housed within select primary care practices which may change based on patient selection
Performs patient outreach, education, and recruitment during start up and then periodically as patient eligibility lists become refreshed
Demonstrates a positive attitude in dealing with problems or crisis situations
Is aware of and follows BWH policies and procedures for general safety, fire safety, parking, proper body mechanics, infection control, attendance, punctuality, and appearance
Works effectively with team members
Demonstrates initiative and creativity to continuously improve services, processes, and other activities that affect quality and utilization
Willingness to be flexible in situations. Performs duties of lesser, equal, or greater responsibility as requested
Assists in preparation for Joint Commission, CMS, and other surveys as applicable to role
Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as established by BWH/Partners
Follows safe practices required for the position
Fulfills any training required by BWH and/or Partners, as appropriate
Brings potential matters of non-compliance to the attention of the supervisor or other appropriate hospital staff
RN, BSN preferred. Master’s Degree preferred
Experience working in a post acute setting such as L-TAC, rehab, skilled nursing facility, or homecare
Ambulatory experience working in a health center or physician’s office preferred
Health care re-imbursement experience preferred
Experience using acute and post acute versions of utilization review criteria such as MCAP, Interqual, and/or Milliman
Current certification in Case Management preferred
Telephonic case management experience required
Experience with adult and geriatric patient populations preferred
Mental health or psychiatric experience preferred
Maintains membership in a care management organization (preferred)
Familiarity with various forms of health care re-imbursement
Superior inter-personal skills
Strong competency working with hospital computer systems and case management systems
Ability to handle routine work, unexpected priorities, and multi-task
Flexible about changing practice sites as patient needs indicate, helping colleagues at other practices and covering during vacations/unexpected illness/holiday time

Caremore Provider Practice RN Care Coordinator Resume Examples & Samples

Requires 5 years nursing experience as an RN
3-5 years case management experience; or any combination of education and experience, which would provide an equivalent background
Experience with Behavioral Health care preferred
Experience in a Medicaid environment with patient population ages 14 and up is preferred

RN, Care Coordinator Resume Examples & Samples

Monitor patient progress and promote early intervention in acute care situations
Provide safe transition of care across the continuum of care
Provide patient education
Promote patient independence and self-management
Demonstrate autonomy being accountable for their practice
Demonstrate the ability to negotiate and influence individual and group decision- making
Adapt to a fluid, dynamic and rapidly changing environment
Demonstrate leadership qualities in the areas of time management, problem solving, decision making, priority setting, delegation, organization, written/verbal communication and listening skills
Works with Beacon Health leadership in the design, implementation and evaluation of the Medical Home care model
Provides regular progress updates to PCP and other members of the care team
Collaborates with the Transitional Care Coordinators to ensure smooth process in place when movement between settings occurs

Icmp RN Care Coordinator Resume Examples & Samples

Works within legal, regulatory, accreditation and ethical practice standards relevant to the position and as
Established by BWH/Partners
Experience working in a post acute setting such as L-TAC, rehab
Ambulatory experience working in a health center or physician’s
Experience using acute and post acute versions of utilization review
Spanish speaking preferred (for Float, Jen Center, Health Center,
Strong competency working with hospital computer systems and
Flexible about changing practice sites as patient needs indicate,

Field Based RN Care Coordinator Resume Examples & Samples

We have needs in the following counties: James City, Williamsburg, York, Poquoson, Hampton, Newport News, Sussex, Surry, Isle of Wight, Norfolk, Portsmouth, Virginia Beach, Chesapeake, Suffolk, Franklin City, South Hampton, Greensville*
Serves as a point of contact for Members and the Interdisciplinary Care Team (ICT) of all physical health, behavioral health and other home and community based services
Provides assistance in resolving concerns about service delivery or providers
Coordinates with enrollees primary care provider, specialists and other providers and care programs to ensure comprehensive, holistic, person-centered approach to care
Reports quantifiable impact, quality of care and/or quality of life improvements as measured against the care coordination goals
Establishes and maintains professional working relations with community resources and care providers
Collaborates with peers on enrollees’ admissions, transitioning and/or discharge planning Refers service requests that do not meet approval criteria to Manager, Director, or RN for further review and determination
Performs other social services-related case management duties as needed
Current and unrestricted Registered Nurse License or Certified in the state of Virginia or hold a multi-state license recognized by Virginia
3+ years of care coordination or behavioral health experience and / or work in a healthcare environment
Proficient computer skills in Microsoft Office, to include Excel, Word, Outlook and the ability to type and talk at the same time and toggle between multiple screens
Experience working with Medicaid / Medicare population
Case management experience in a clinical setting (hospital, long term care, home health, hospice) or managed care

RN Care Coordinator ACT Resume Examples & Samples

Identification
Gathers all relevant data, objectively evaluates data, and obtains information by communicating with the patient/patient’s family, the healthcare provider and other members of the healthcare delivery team and patient’s community support network including external healthcare providers/agencies
Supports assessment by other care management professionals in specialty and inpatient areas as patient needs those services
Maintains high level telephonic oversight of the integrated plan and assures goals are met and/or addressed
Works with patient/family/healthcare providers/community support to coordinate needed services
Reviews health care benefits, coordinates plan with the benefits
Identifies alternate sources of funding if available for services not eligible for benefits
Leads and/or supports transition/discharge planning for patients moving between levels of care
Follows the patient over time, across all sites of care to measure effectiveness of the plan. Adapts plan to meet changing needs

RN, Care Coordinator Resume Examples & Samples

Increase patients' compliance with treatment plans
Engage community resources to support the patient's optimal functioning; and improve collaborative coordination of care to affect waste and inefficiency
Provide telephonic and/or face-to-face follow up with patients for care coordination services
Prepare for and attend committee meetings as assigned
Customer service skills with the ability to interact professionally and effectively with providers, third party payers, physicians, and staff from all departments within and outside the Company
Creative thinking skills with the ability to ask the needed bigger-picture questions that lead to process and team improvements
RN with current state licensure
Experience working with CMS preferred
Personal computer experience should include working with Microsoft Word, Excel, PowerPoint and Outlook at the intermediate level at a minimum

Field Based RN Care Coordinator Resume Examples & Samples

Engage community resources to support the patient's optimal functioning; and improve collaborative coordination of care to affect waste and inefficiency. This position will be based remotely from a home office and requires travel within the Jackson region. Responsibilities
Facilitate provider contact as needed to coordinate patient's care needs
Identify high risk patients for disease management and care coordination and work with patient, physician and other health care providers to establish a plan of care to meet the patient's individual needs
Provide telephonic and/or face to face follow up with patients for care coordination services
Telephonic contact and/or face to face with identified patients to explain the care coordination program, assess needs, educate patient regarding the disease as appropriate
Telephonic contact and/or face to face to instruct the patient on how to access the program resources, suggest and/ or arrange follow-up including mailing of educational materials, contact with community resources, and physician follow up visits; document the contact into the care coordination documentation system
Phone and/or face to face support on setting up and using care coordination tools or equipment placed in the patient's home
Take calls from patients and providers and give them appropriate information to help coordinate services
Manage patients in current disease management programs, completing and revising as necessary, the information in care coordination documentation system
RN with current and unrestricted state licensure
CCM and/or related certification or eligible to take exam within two years of employment is preferred

Field Based RN Care Coordinator Resume Examples & Samples

We have needs in the following counties: Lunenburg, Charlotte, Halifax, Greenville, Brunswick, Mecklenburg, Nottoway, Sussex, Surry*
Conducts initial and follow - up assessments within designated timeframes on enrollees identified as having complex case management needs (assessment areas include clinical, behavioral, social, environmental and financial)
Monitors hospitalizations and institutional facility admissions and re - admissions to identify issues and implement strategies to improve outcomes
Coordinates with enrollees primary care provider, specialists and other providers and care programs to ensure comprehensive, holistic, person - centered approach to care
Reports quantifiable impact, quality of care and / or quality of life improvements as measured against the care coordination goals
Current and unrestricted Registered Nurse License or Certified in the state of Virginia or hold a multi - state license recognized by Virginia

Field Based RN Care Coordinator Resume Examples & Samples

Routinely assesses and monitors enrollees’ status, needs and progress; if progress is static or regressive, determine reason and proactively encourage appropriate adjustments to the plan of care, providers and / or services to promote better outcomes
Collaborates with peers on enrollees’ admissions, transitioning and / or discharge planning Refers service requests that do not meet approval criteria to Manager, Director, or RN for further review and determination
Experience working with members who have complex medical needs, the elderly, individuals with physical disabilities, and/or those who may have communication barriers

RN Care Coordinator Breast Cancer Resume Examples & Samples

CPR/BLS certification
Ability to provide age appropriate cancer education
Strong organizational, communication, and customer relation skills
Knowledge of and ability to utilize in-house and external oncology resources
Ability to multitask and function in a stressful, fast-paced environment
Self-motivated with ability to work independently
Three years of experience in Oncology Nursing OR breast care/breast cancer nursing practice
Proficient in Microsoft Office, particularly Outlook, Word, Excel, Power Point, Access (preferred)
Bachelor’s and/or Master’s degrees in Nursing (preferred)
Five years experience in Oncology Nursing or breast care/breast cancer nursing practice (preferred)
Current license with Florida State Board of Nursing as a registered professional nurse
National Certification: Oncology Certified Nurse (OCN) through the Oncology Nursing Certification Corporation
Breast Care Certification through the Oncology Nursing Certification Corporation

RN, Care Coordinator Resume Examples & Samples

Evaluates members for case management services and determines appropriate level of care coordination/ management services for member
Develops and monitors members plan of care, to include progress toward meeting established goals and self-management activities
Act as liaison and member advocate between the member/family, physician and facilities/agencies
Travel to inpatient bedside, member's home, provider's office, hospitals, etc required with dependable car. May spend up to 70% of time traveling with exposure to inclement weather and normal road hazards. May require climbing multiple flights of stairs to a member's home, provider's office, etc
Preferred - Bachelor's Degree in Health Services or Nursing
Required - 2+ years of experience in clinical acute care
Preferred - Prior utilization management experience
Preferred - Experience in care of the elderly
Preferred - Experience in home health, physicians office or public health
Ability to multi-task Bilingual skills a plus
Ability to work independently Ability to work independently, handle multiple assignments and prioritize workload
Required - Healthcare Management Systems (Generic)

RN Care Coordinator / Discharge Planner Resume Examples & Samples

Licensed in the State of Maine as a Professional Nurse, BSN preferred
Minimum of two years recent clinical experience and knowledge of discharge planning required
Experience using an Electronic Health Record and ability to maintain accurate and timely documentation
Strong conflict resolution and problem solving skills
Must be a team player with a positive attitude and self-motivation
Demonstrates professional responsibility in the role of RN Care Coordinator/Discharge Planner
Conforms to all requirements of Medicare and MaineCare, and keeps current to all changing laws and requirements
Provides care coordination and discharge planning daily and works collaboratively with all physicians, UR staff, social services, and outside facilities to best meet the needs of all patients
Participates in Continuing Education and other pertinent learning opportunities to maintain and increase personal and professional growth
Utilizes work time appropriately to maximize productivity
Begins initial discharge planning assessment within 24 hours of admission
Determines degree of discharge planning need on an individual basis
Performs surveillance and data collection as directed for trend recognition and development of effective actions/plans
Educates patients upon discharge using the teach back method
Provides intervention as indicated, such as to Social Services for resource, financial, or emotional support or Home Health, Skilled Care, or LTC depending on level of need
Attend daily PEP rounds to discuss and review discharge plan of care
Work diligently to remove barriers to patient’s timely discharge
Assess an individual’s needs and works with them to develop a comprehensive plan that promotes long-term health, relapse prevention, and that will be something the patient is likely to follow
Review and discusses the discharge plan with the patient, family, and staff to ensure everyone understands and agrees to follow it
Makes discharge follow up telephone calls to review the hospital d/c instructions, d/c plan, medications, and answer any questions, address any concerns, and provide any new referrals needed

RN Care Coordinator Manager Resume Examples & Samples

Obtains and reviews monthly Care Gap data from the Managed Care Department for Family Medicine and General Medicine clinics
Assigns Care Gaps to be worked to the Medical Assistant Care Coordinators
Obtains and reviews daily ED visit reports to identify high ED utilizers
Facilitates post ED follow up visits with PCPs
Facilitates contact with insurance Case Managers and implements plans with Case Managers to follow up with patients, to include phone calls, video discussions, and assists in preventing or reducing ED visits
Assists with patients’ needs, to include transportation and referrals to mental health providers, if needed
Obtains daily list of hospital-discharged patients and assigns to Medical Assistant Care Coordinators to coordinate needed post discharge and transition of care visits
Establishes/reviews high-risk patients and establish plans for close follow-up and special needs
Reviews Healthy Planet Performance of each clinic monthly and identifies measures that require improvement, and communicates to clinic Medical Director and leadership
Reviews HEDIS scores of each provider with assigned Medical Director to establish and discuss plans for improvement with respective clinic Medical Directors
Meets with clinic Medical Directors periodically for updates and to discuss ways to improve measures, Care Gaps and scores
Participates in monthly Value Based Funding Team Meetings
Distributes reports to individual clinics
Provides peer-level patient/caregiver education and encouragement
Maintains database of and relationship with community resource providers
Maintains patient privacy
Acts in an ethical and professional manner in accordance with organization’s code of ethics for nursing
Acquires and maintains knowledge and skills in nursing practice to contribute to the professional development of self, peers, colleagues, and others
Knowledge of regulatory agency standards (e.g. JCAHO, HRS)
Nursing Standards and Florida Nurse Practice Act
Demonstrated Clinical skill in area of ambulatory care and/or particular specialization
Basic management skills
Ability to serve as resource for the nursing process

Rn-care Coordinator Resume Examples & Samples

Coordinates staff scheduling and educational/development activities
Identifies and resolves issues affecting the delivery of patient care. Performs quality assurance studies and assists with implementation of quality assurance and/or improvement initiatives
Monitors departmental compliance with regulatory and compliance requirements
Three years of experience working as a Registered Nurse required

Rn-care Coordinator Resume Examples & Samples

Provides pro-active initial and on-going clinical assessments of patient's medical, financial, functional and psychosocial needs to assist in development of a care plan to ensure a safe and timely discharge
Coordinates with both internal and external care team members to ensure a safe transition to the next level of care through planning and implementation of both skilled services and community resources. Ensures choice has been provided to the patient
Participates as an active member of the case management team to provide care coordination services to patients identified through referrals, nurse rounding and collaboration with the multidisciplinary team
Serves as the clinical resource to the Case Management department as well as nursing units in seeking opportunities to improve care coordination for all patients and for specific populations
Provides excellent care coordination services that are patient centered through clear, concise written and verbal communication and on-going collaboration with all members of the care team including the patient/family/caregivers
Coordinates, leads and participates in multidisciplinary case conferencing as needed to ensure an effective plan of care that is consistent with the patient's goals
Collaborates with the Utilization Review RN in ensuring appropriate level of care and efficient utilization of services throughout the patient's stay. Educates patients/family/caregiver on medical necessity and appropriate level of care and alternatives for care
Serves as a resource to internal customers on medical necessity and appropriate level of care
All associates of SCL Health System are expected to meet the following in their day-to-day work
Be available to work as scheduled and report to work on time
Be available to work overtime if needed
Be willing to accept supervision and work well with others
Be respectful of all with whom you interact and act in a professional manner
Be well groomed and dressed appropriately for your role
Be in compliance with all SCL Health System policies
Be sufficiently rested to perform your duties throughout the period assigned
Demonstrate a willingness to learn
Be able to communicate clearly, think clearly, and concentrate on assigned tasks
Be willing to perform other duties as assigned

Telephonic RN Care Coordinator Resume Examples & Samples

Engaging members / families telephonically and or face to face to coordinate services, community resources and treatment needs
Act as the primary point of contact for Members and the Interdisciplinary Care Team (ICT)
Current, unrestricted RN licensure in the state of Virginia
At least 1 year experience directly working with individuals with complex medical or behavioral needs
Basic level of proficiency in Microsoft Office suite applications (Word, Excel, Outlook / Email, Internet), including the ability to type and talk at the same time and toggle between multiple applications
Telephonic / Call Center experience

Telephonic High Risk RN Care Coordinator Resume Examples & Samples

Delivering a holistic approach to coordinated care based on the member’s needs using a person centered philosophy
Collaborating with the member's PCP to deliver and coordinate necessary services
2+ years recent experience in case management, home care, long term care and / or experience in acute or rehab care setting
Experience with Medicare and / or Medicaid
Managed Care / Case management experience
CCM certification

RN, Care Coordinator Resume Examples & Samples

Performs utilization review in accordance with all state and federal mandated regulations
Reviews member records and, using approved criteria and member benefit information, ensures appropriate and cost‐effective healthcare services to members
Reviews service requests submitted by physicians to include review of evidence/clinical and medical necessity
Contacts identified members or providers to explain the program, assess needs, educate regarding the program resources, facilitating physician visits, etc., and documenting the contact in the appropriate electronic record systems
Consults and works closely with the Director of Medical Management and with the Medical Director regarding care that doesn't appear to meet approved medical criteria
Complete administrative denials when appropriate
Provide Tier 2 process review as assigned by Pre Cert Manager and/or Director
Two years' utilization review or case/care management experience within a hospital, home health setting, outpatient clinic or managed care company
Must have experience working within CMS and internal quality guidelines