nurse care coordinator

Oregon Health & Science University

<div>Department Overview:

The Comprehensive Pain Center (CPC) is among the largest pain centers in the region, offering treatment options for patients with acute (short-term), chronic (long-term) pain, and pain caused by cancer. We also provide many treatments that address the physical, mental, and behavioral issues that can result due to ongoing pain. The Oncology Nurse Care Coordinator acts as primary point of contact for oncology pain patients after referral to the CPC, and until the patient has sufficient knowledge and resources to direct self-care. They have responsibility for monitoring, coordinating care, and educating cancer patients and families as they move through the CPC.
Function/Duties of Position:

The Oncology Nurse Care Coordinator acts as primary point of contact for oncology pain patients after referral to the CPC, and until the patient has sufficient knowledge and resources to direct self-care. They have responsibility for monitoring, coordinating care, and educating cancer patients and families as they move through the CPC.
Builds awareness of CPC oncology among CPC providers and other OHSU referring providers.
Responds to criteria-based referrals as soon as possible, no longer than 24 hours, and schedules with appropriate provider within 72 hours. Responds to patient phone calls within 24 hours. 
Gather pertinent information about the patient&rsquo;s medical, psychosocial, functional and insurance status. Communicate with the multidisciplinary team (MDs, APPs, nurses, pain psychologists, Supervisors, Manager, PAS Staff, MCC&rsquo;s).
Communicates with other department or external providers to coordinate care for patients.
Provides direct access for patients to answer questions about care and schedule via phone or Mychart.
Provides information about our program with newly hired RNs in Oncology to introduce the CPC, the CPC Oncology RN Coordinator role, and contact information. 
Facilitates multidisciplinary collaboration when indicated by complexity of patient&rsquo;s clinical condition, medical management, or other barriers to care plan.
Provides necessary education and information on available options, the informed decision-making process, and realistic goal setting in order to empower the patient/caregiver to actively participate in their plan of care.
This position schedules appointments for patients to ensure coordinated care and meeting scheduling metrics for CPC oncology patients. Responds to patient questions and needs via electronic medical record (Epic) and telephone within established turn-around time metrics. 
Provides post-visit instruction and education, enters orders as requested. Follows up with patients by telephone following procedures to assess status. Participates in ongoing professional development and competency assessment. Maintains knowledge of life safety, patient safety, fire and electrical safety and disaster plan. Responds appropriately in emergency situations. Performs other duties needed to ensure smooth patient flow and clinical operations. Performs other duties as assigned. 
Covers CPC Triage RN duties as needed when Triage nurses are out. 
Performs other duties as assigned. Performs RN Visits as appropriate for continuity of care, follow-up on past procedures, and readiness and appropriateness for potential future procedures, which may include scheduling of appointments, placing orders for procedures, and communicating with providers. Communicates with Managed Care team regarding insurance concerns for procedure appointments. 
Department Specific: 
This position is eligible for full-time remote work but may have occasion to work on-site in clinic as needed. 
This work will have multiple demands and interruptions. Ability to prioritize competing needs to accomplish tasks 
Heavy use of computers<ul><li> 
Excellent communication and organizational skills</li><li>Strong triage skills</li><li>Broad knowledge of community health concepts, services, and resources.</li><li>Competent in basic computer skills.</li></ul> 

Required Qualifications:
<ul><li>Two years experience as a RN providing direct hands-on patient care</li><li>Current unencumbered Oregon RN license</li><li>Current unencumbered Washington RN license</li><li>BSN Graduates: Baccalaureate Degree in Nursing from a program accredited by Commission of Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN) or Commission for Nursing Education Accreditation (CNEA) 30 days before start date.</li><li>ADN Graduates: Associate Degree in Nursing from an accredited program 30 days before the start date.</li><li>Associate degree Nurses required to enroll in BSN program within 3 years of hire and complete within 5 years of hire</li><li>BLS at time of hire and must be issued by the American Heart Association (AHA)</li><li>BLS must not expire during orientation</li><li>Must be able to perform the essential functions of the position with or without accommodation</li></ul>
Preferred Qualifications:
<ul><li>Experience in an ambulatory setting</li><li>Prior experience working with chronic pain patients</li><li>Familiarity with pain procedures and pain medications</li><li>Familiarity with cancer patients.</li><li>Pain Management Nursing Certification</li></ul>
Additional Details:
<div>
Length of Orientation &ndash; Experienced Nurse</div><ul><li>
External candidates: OHSU &amp; Nursing New Employee Orientation (NEO) for about a week.</li><li>
Either Transition to Practice (TTP) Program Specialty Fellowship/Fellowship Learning Pathway or Orientation experience for 3 days-26 weeks depending on the care area. An employment service agreement may apply.</li></ul> 
This position also comes with great benefits! Some highlights include:<ul><li>
Comprehensive health care plans. Covered at 100% of the cost for full-time employees and 88% for dependents.</li><li>
$50K of term life insurance provided at no cost to the employee</li><li>
Two separate above market pension plans to choose from</li><li>
Vacation - 192 to 288 hours per year depending on length of service, prorated for part-time</li><li>
Holidays - up to 64 holiday hours per calendar year (employees accrue .0308 holiday hours for each hour paid &ndash; included in vacation accruals)</li><li>
Sick Leave - 96 hours per year, prorated for part-time</li><li>
Substantial public transportation discounts (Tri-met and C-Tran)</li><li>
Tuition Reimbursement</li><li>
Innovative Employee Assistance Program (EAP) including extensive wellness resources</li></ul> 

Why apply to OHSU?: We are Oregon's only public academic health center. In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu</div>

Oncology Nurse Care Coordinator

US Department of Veterans Affairs

Registered Nurse (Care Coordinator)

Diabetes-Endocrine Registered Nurse Care Coordinator

Brilliant Care

About Brilliant Care:Brilliant Care is a very innovative, fast-growing, mission-driven population health management company that assists with value based care initiatives. Our objective is simple: improve health outcomes and reduce total cost of care.We proactively identify at-risk hypertensive, diabetic and CHF patients and provide them with personalized access to a nurse care manager who works as an extension to the provider. Using high-touch care coordination and advanced remote technologies, we improve patient compliance and medication adherence while reducing unnecessary ER and hospital visits.Essentially, we help improve outcomes substantially, without heavy lift or any out-of-pocket costs for healthcare organizations.Duties and Responsibilities:This position will assist healthcare providers and practices to successfully manage their care management and remote patient monitoring program and provide remote patient monitoring services to patients who are enrolled in the program. Must have a passion for educating patient on how to manage their chronic conditions, be self-driven to meet required monthly goals, and have ability to maintain flexibility in a constantly changing environment.Patient Enrollment:<ul><li>Enroll patients in Remote Patient Monitoring (RPM).</li><li>Possess the skill to verbally train and educate patients on how to use devices</li></ul>Data Collection:<ul><li>Monitor daily capture of patient physiologic data from devices</li><li>Conduct coaching call to remind patients to capture daily data</li><li>Follow-up with non-compliant patients</li></ul>Care Management:<ul><li>Act as primary contact for patients to build rapport and maintain patient satisfaction, improvement in health status, and compliance with program</li><li>Analyze collected data and triage out of range readings in a timely manner</li><li>Escalate cases which require provider attention</li><li>Provide health coaching to high-risk diabetic, hypertensive, and congestive heart failure patients</li><li>Document assessment data, education provided, and lifestyle interventions planned in patient charts</li><li>Capture detailed and concise notes of all patient interactions</li><li>Act as a resource to patients and providers in enabling access to the provider and presenting information to the provider for medical decision-making</li></ul>Provider &amp; practice management:<ul><li>Understand physician and practice challenges or objections which come in their way of enrolling patients in RPM</li><li>Professionally address provider expressed challenges and workflow related issues to ensure program success</li><li>Possess ability to change workflow and processes as requested by provider or practice</li><li>Communicate with provider of patient needs and institute care changes per provider instructions</li></ul>Education &amp; Experience:<ul><li>Active LPN or RN license required. Candidates must hold a current California nursing license. A compact license is strongly preferred; however, candidates with a California license who are willing to obtain additional state licenses will be considered.</li><li>Min 3-year work experience working in practice or healthcare setting.</li></ul>Location:Work from home. This particular position requires GA, MD, NY, PA, SC, TX or VA residency, with understanding that this role will be working 8am-5pm CST.Job Type: Full-timeSalary:$26.00 - $28.00 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Parental leave</li><li>Vision insurance</li></ul>Medical specialties:<ul><li>Cardiology</li><li>Geriatrics</li><li>Primary Care</li></ul>Schedule:<ul><li>Monday to Friday</li></ul>Application Question(s):<ul><li>What is your minimum targeted compensation for this role? Please specify whether salaried or hourly.</li><li>Do you have a valid LPN or RN License?</li><li>We require a minimum of 3 years of clinical experience as an LPN or RN. Do you possess at least 3 years of professional nursing experience?</li><li>Do you have a background in bedside, telehealth, skilled nursing or outpatient environments?</li></ul>Work Location: <ul><li>Remote</li><li>Must currently reside in the state of California.</li></ul>Job Type: Full-timePay: $26.00 - $28.00 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Parental leave</li><li>Vision insurance</li></ul>Application Question(s):<ul><li>Do you have a background in bedside, telehealth, skilled nursing or outpatient environments? </li><li>Do you have a minimum of 3 years of clinical experience as an LPN or RN? </li><li>This position pays between $26 and $28 per hour on a W2 basis. Is that within your desired / targeted hourly compensation for a role of this nature?</li><li>What is your current nursing license status? (Active LPN or RN license required. Candidates must hold a current California nursing license. A compact license is strongly preferred)</li></ul>Location:<ul><li>California (Required)</li></ul>Work Location: Remote

Remote Nurse Care Coordinator, Full-time (California)

Registered Nurse- Community Care Coordinator

Registered Nurse _ Community Care Coordinator

Children's Wisconsin

<div>At Children&rsquo;s Wisconsin, we believe kids deserve the best.
Children&rsquo;s Wisconsin is a nationally recognized health system dedicated solely to the health and well-being of children. We provide primary care, specialty care, urgent care, emergency care, community health services, foster and adoption services, child and family counseling, child advocacy services and family resource centers. Our reputation draws patients and families from around the country.
We offer a wide variety of rewarding career opportunities and are seeking individuals dedicated to helping us achieve our vision of the healthiest kids in the country. If you want to work for an organization that makes a difference for children and families, and encourages you to be at your best every day, please apply today.
Please follow this link for a closer look at what it&rsquo;s like to work at Children&rsquo;s Wisconsin: https://www.instagram.com/lifeatcw/
Children&rsquo;s Wisconsin is seeking a full‑time Nurse Clinician to join our renowned Genetics and Genomics Program, a leading center for the diagnosis, treatment, and research of genetic conditions. Our team provides compassionate, expert care to both children and adults across the lifespan, making a meaningful impact on patients and families every day.
In this role, the Nurse Clinician serves as a primary care coordinator and clinical follow‑up partner for patients with genetic disorders. You will manage an ongoing caseload, developing long‑term relationships with patients and families while guiding care over time. Responsibilities include coordinating treatments, supporting families with next steps following diagnosis, ensuring insurance coverage, and providing triage support by phone.
The role offers a balance of approximately 60% phone‑based care coordination and triage and 40% in‑person clinic support, including seeing patients in clinic alongside the care team. There would be little to no procedural tasks.
This position offers a high level of autonomy, with the opportunity to truly manage and own your patient caseload while collaborating closely with providers and specialists. Continuous learning are a core part of the role&mdash;genetics is an ever‑evolving field, and curiosity, humility, and a willingness to ask questions are essential. Most nurses feel comfortable in the role after about two years, with strong support and resources along the way.
Work Schedule: 1st shift Monday thru Friday no weekends or holidays.
Hybrid Schedule : Working two days from home and 3 days in the office
Location: Wauwatosa Main campus
<div>What you will do:
 
 
The Ambulatory Nurse Clinician promotes optimal wellness by promoting health maintenance, participating in the management of acute illness, managing the effects of chronic disease and disability across the continuum of care. This is accomplished through face to face or electronic interactions. Utilizing critical thinking and nursing process in caring for patients and caregivers with complex healthcare needs which are acquired through a process of integrating education, experiential knowledge and evidence-based guidelines. Acting as a partner, advocate, support and teacher to the patient and caregivers providing optimal management of the child's health care, and respecting their culture, values, diverse individual needs, health goals and treatment preferences. The Nurse Clinician facilitates continuity of care using the nursing process, inter-professional collaboration and care coordination activities to support the whole child by assessing and providing access to appropriate health care services and community resources across the care continuum.
 
 
Essential Functions
 
 
<ul><li>Accountable for and coordinates the delivery of care within the practice setting and across health care settings to maintain continuity of care to create a compassionate therapeutic environment through the assessment of the physical, functional and psychosocial well-being of the patient and family.
</li><li>Uses clinical reasoning to develop, implement and evaluate a plan of care that is collaborative and addresses the needs of the patient and caregivers resulting in optimal patient outcomes and reducing risk factors.
</li><li>Utilizes an inter-professional approach to communicate, educate and engage patients, caregivers, and providers in implementing the plan of care across care settings to achieve common goals, individualized interventions and optimal positive clinical outcomes and disease management.
</li><li>Employs educational strategies utilizing health teaching and health-promotion to include but not limited to, learning needs, abilities, readiness, cultural and spiritual, language preferences and barriers to learning that promote staff, individual, family, community and population health and safety and patient self-efficacy to promote, maintain, or restore health.
</li><li>Communicates effectively using health literacy strategies and a variety of formats, tools, approaches and technologies to build professional relationships and deliver care across the continuum.
</li><li>Contributes to the development and application of clinical practice guidelines, policies and procedures by comparing, contrasting and evaluating possible alternatives using an evidence based format and continuous quality improvement to deliver quality nursing care and enhance the patient/caregiver experience.
</li><li>Advocates from perspective of patient/caregiver and works toward resolution of complex ethical issues and raises ethical questions and concerns with the interdisciplinary team to identify inequities in care and works to resolve them.
</li><li>Through various telehealth practices provides effective management and coordination of care and services to include telephone triage and other telecommunications technologies to remove time and distance barriers for the delivery of nursing care.
</li></ul> 
Education:
 
 
<ul><li>Associate's Degree in Nursing required
</li><li>Bachelor's Degree in Nursing preferred
</li></ul> 
Experience:
 
 
<ul><li>2+ years Licensed nursing experience required
</li><li>2+ years Pediatric nursing experience preferred
</li><li>Experience managing patients with chronic and complex family and health needs preferred
</li></ul> 
Knowledge, Skills and Abilities
 
 
<ul><li>Demonstrate proficient pediatric assessment skills, utilizing a developmental approach to meet the individual needs of the neonatal, infant, toddler, pre-school, school age and adolescent and or young adult patient.
</li><li>Ability to work with patients who have intellectual and physical disabilities in a developmentally appropriate manner.
</li><li>Proficiency with the use of computers and an electronic medical record.
</li><li>Independent judgment and analytical ability to problem solve, make decisions and formulate reports.
</li><li>Requires effective and collaborative interpersonal and communication skills for discussing sensitive issues with patients and caregivers.
</li><li>The ability to represent the organization and serve consumers in a professional manner and promote a positive image of the organization and its services.
</li><li>Expertise in active listening and therapeutic communication.
</li><li>Requires critical reasoning and astute clinical judgment to expedite appropriate care and treatment.
</li></ul> 
Licenses and Certifications:
 
 
- BLS-Basic Life Support Healthcare Provider - American Heart Association/American Red Cross/National Safety Council required
 
- + one of the following: - N/A
 
- License RN-Registered Nurse (30) - State of Wisconsin
</div>Children's Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.
Certifications/Licenses:
+ one of the following: - N/A, BLS-Basic Life Support Healthcare Provider - American Heart Association/American Red Cross/National Safety Council, License RN-Registered Nurse (30) - State of Wisconsin, License RN-Registered Nurse (TN Compact) - State of Tennessee</div>

Nurse Clinician- Genetics (Hybrid)

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