RN POPULATION CARE COORDINATOR (JOB ID #10760)

Kearny Mesa - Full-Time

Rady Children’s Physician Management Services (RCPMS) offers exciting opportunities for qualified candidates to join our rapidly growing organization. We are a wholly owned subsidiary of Rady Children’s Hospital and Health Center with just over 500 employees. RCPMS supports primary care pediatricians with 32 office locations throughout San Diego and Southern Riverside Counties.

Under the supervision of an Associate Director and in collaboration with the CPCMG Director of Population Health, the RN Population Health Care Coordinator (RNPHCC) will support the goal of improving and coordinating care in high-risk patients and populations and help in the development of patient-centered, team-based care (medical home model) for those patients. The RNPHCC will help to identify and manage higher-risk and clinically complex patients and coordinate care between the medical home, the family, community agencies and external resources with a focus on the management of those diagnoses that require more intensive coordination of services, enhanced linkages with community agencies and specialists, and a broader focus on preventing complications. The goal of the RNPHCC will be to positively impact the quality of care and patient experience while reaching quality benchmarks and integrating care-coordination work with the patient’s medical home. The RNPCC interfaces with the individual patient, creating plans of care with an interdisciplinary approach, and helps identify new directions and strategies for population health management at CPCMG. This role will include assisting in the development and maintenance of patient registries, and helping to analyze and identify trends in care that can help various patient populations within CPCMG as a whole.

Responsibilities:

Identify, track, and follow care for higher risk patients in specific categories and population groups, as identified by CPCMG providers or the CPCMG Quality Assurance and Population Health (QAPH) Plan. These patients may have notable care gaps or challenging needs that require linkages with internal and external resources. Such activity may require the development of an active and modifiable patient registry.
Coordinate referral orders or care plans for high risk patients in conjunction with referral coordinators, external care managers, and other staff involved in the care of the patients.
Communicate with patients and families in a timely manner, according to company guidelines, and utilize nursing skills and appropriate clinical decision-making in helping identify care gaps and needs
Provide appropriate resource information and education to targeted populations and high risk patient population
Collect, organize, track and report data for the patients that are contacted and managed. This activity requires the ability to manage a patient registry.
Provide monthly reports to CPCMG and RCPMS leadership
Adheres to established policies and procedures, standards of care, and standards of professional performance within scope of licensure/certification
Assist such identified higher risk patients and populations with issues related to pharmacies and medications.
Under physician direction for such patients, communicate with the parent/ guardian regarding diagnostic tests, imaging studies, and referrals and follow-up care as indicated.

Requirements:

Graduate of an accredited School of Nursing
Minimum of one year professional nursing experience in pediatrics preferred
Care Coordination or Care Management experience (with individual patients and larger populations) and experience in pediatric patient teaching desired
Current RN license in the state of California
Current BLS certificate

If you want to work with a great group of people, we invite you to join us in promoting the health of children within our communities.

For full-time positions RCPMS offers the full scope of benefits, a competitive compensation package and opportunities for professional growth.

Rady Children’s Physician Management Services is proud to be an Equal Opportunity Employer.

To be considered, please submit a resume and cover letter.

The reasonably expected starting hourly wage range for this position is $45-$50 depending on qualifications including education and relevant experience.

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