Patient Care Coordinator, RN

• Are you a compassionate Registered Nurse looking to make a meaningful impact in patient care?
• Join our growing team of Patient Care Coordinators (PCC) at WGH, where we focus on improving outcomes through chronic care management, transitional care management, and quality initiatives.
• As a PCC RN, you'll work in a non-traditional, office-based role that allows you to build lasting relationships with your patients.
• You'll manage your own panel of patients, providing monthly check-ins, follow-up calls after discharge, and engaging in community outreach to identify and support those in need.
• At the heart of this role is patient advocacy - connecting individuals with resources and support to enhance their care and overall well-being.

The Patient Care Coordinator assists the physician or mid-level provider in formulating and implementing a care management plan that addresses the patients identified needs by assessing the patient/family needs, issues, resources, and care goals; determining the choices available to individual patients; educating the patient/family on the choices available. Establishes a care management plan that is mutually agreed upon by the health care team and the patient/family. Plans will contain specific mutual self-management goals, objectives, and interventions with the patients are action-oriented.

Duties

include, but are not limited to, educating patients and their families, making referrals to other care providers by providing chronic care management services for patients. Duties will also include transitional care follow up calls for recently discharged patients, Medicare annual wellness screenings, and improving communication among care providers to improve patient outcomes. Will review utilization and quality reports routinely to identify patient gaps in care and any needs for additional support of the care management team.

Schedule

Monday-Friday, 8:00 am - 4:30 pm

Requirments

• Graduate of an accredited school of nursing
• Current license as a registered nurse
• Current CPR certification
• Clinical experience preferred but not required
• Ability to perform functions with minimal supervision
• Effective telephone communication skills
• Proficiency in medication indications and side effects, understanding of medical tests and requirements for tests