Role Overview: The Complex Care Coordinator is responsible for assessing and managing the care needs of complex patients, ensuring safe and timely discharge plans, and coordinating care across the continuum. They serve as an expert resource for clinical, psychosocial, and resource-related issues, collaborating with patients, families, and interdisciplinary teams to optimize outcomes.
Key Responsibilities:
- Conduct comprehensive clinical and psychosocial assessments for high-risk, long-stay, or difficult-to-place patients.
- Develop and implement discharge plans, identify barriers, and facilitate post-acute referrals.
- Partner with healthcare team members and community agencies to coordinate resources, social services, and support systems.
- Serve as a specialist on complex psychosocial, end-of-life, and social determinant issues, providing guidance and resource information.
- Mentor and precept new staff and interns, sharing expertise on complex patient cases and family dynamics.
- Participate in interdisciplinary rounds, advocate for patient needs, and ensure proper documentation of assessments and care plans.
- Support compliance with policies, regulations, and continuous professional development.
Qualifications & Skills:
- Associates or Bachelor’s Degree in Nursing; RN license required, with multi-state licensure preferred.
- Minimum 3 years healthcare experience, with at least 2 years in care coordination within an acute setting.
- Current BLS certification.
- Excellent communication, assessment, organizational, and problem-solving skills.
- Knowledge of healthcare regulations, community resources, and social determinants of health.
- Ability to work collaboratively, handle stress, and adapt in a fast-paced environment.
Join a team dedicated to compassionate, patient-centered care, leveraging clinical expertise and resource coordination to improve patient outcomes and experience.