Registered Nurse/Clinical Coordinator (RWW)

Company Name:
Summary: Manage the provision of individual patient services and coordinate/collaborate with the clinical staff to develop the patient rehabilitation plan. Provide follow-up skilled nursing visits for patients in compliance with the state Registered Nurse Practice Act. Monitor the provision of rehabilitation service/outcomes and comminicate regularly with the patient, family, physician and payers. Work under general supervision.
Essential Duties and Responsibilities:
Admits patients to the services, completing appropriate clinical documentation under the Director of Clinical Management''s direction. Assesses individual status and care/instruction needed by the patient.
Manage the provision of individual patient services and collaborate with clinical staff to develop rehabilitation plans and utilize professional staff. Coordinate the ongoing provision of rehabilitation services.
Formulate rehabilitation treatment plans, functional outcomes/goals and service delivery for referred patients in conjunction with Clinical Assessors.
Develop patient initial progress and discharge reports, monitor status of the person served.
Reports patient care/condition/progress to patient''s physician and Director of Clinical Management on a continuous basis. Analyzes any changes in a patient''s condition, identifying symptoms and severity while alerting the physician and Director of Clinical Management promptly.
Implements patient care plan in conjunction with patient and family to asssist them in achieving optimal resolution of needs/problems. Provides skilled nursing care per the physician''s plan of care/treatment and in compliance with Nurse Practice Act. Instructs various health care personnel on patient medication, diets, disease process and patient self-care.
May coordinate/oversee/supervise the work of Home Health Aiides, Certified Home Health Aides and Personal Care Workers and provides written personal care instructions/care plan that reflect current plan of care. May monitor the appropriate completion of documentation by home health aides/personal care workers as part of the supervisory/leadership responsibility.
Monitor patient, family, physician and payor satisfaction with the program on a regular basis.
Schedule/facilitate interdisciplinary case conferences with all therapists, payers and family members.
Communicate regularly with family, payor and physician regarding patient progress.
Arrange for provision of necessary equipment to enable achievement of agreed upon functional goals (i.e. HMO, insurance carrier, etc.) with funding source.
Participate in physician''s meetings to report/resolve medical issues for caseload.
Monitor projected hours of service to be delivered to patient and report hours/subsequent changes to the Director Clinical Management.
Negotiate with funding sources for extensions of service beyond initial authorizations.
Participate in Program Evaluation, Quality Assurance, and in establishing the clinical direction of the program.
Maintain the highest standards of professional conduct in relation to information that is confidential in nature. Share information only when the recipient''s right to access is clearly established and the sharing of such information is clearly in the best interest of the person served.
Attend, participate in and/or conduct internal staff development programs, obtain continuing education as required by Company policy and regulations. Maintain and enhance clinical practice skills.
Perform other duties as assigned in response to the person served, office and/or program needs.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
The candidate must successfully complete any/all required pre-employment evaluation test (s) per policy in each assigned area of practice. Good organizational and communication skills are needed. Ability to function with minimum supervision. Reliable transportation is required. The candidate will have the physical ability to perform job related duties which may require lifting, standing, bending, stooping, stretching, walking, pushing and pulling with or without reasonable accommodation.
Diploma, Associate or Baccalaureate Degree in Nursing with six months experience in area of specialty/desired practice. Current unrestricted licensure to practice as a Registered Nurse in the state (s) to which assigned with current CPR certification required. Case management and/or insurance administration experience in a rehabilitation setting with neurological impaired patients preferable. Maintain professional license and/or certification as required by the state in which the clinical coordinator practices. Effective communication skills also required.

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