Care Coordinator, RN Job at Massachusetts General Hospital(MGH)
Care Coordinator, RN
- (3243631)
GENERAL SUMMARY/ OVERVIEW STATEMENT: Summarize the nature and level of work performed.
SCOPE OF POSITION
This position reports directly to the Administrative Manager and receives general direction from the Chiefs of Center for Courageous Kids. This position is a per diem position funded through the Center for Courageous Kids (CCK) Sundry.
The role of the Center for Courageous Kids Nurse Care Coordinator is to provide coordination of care to pediatric patients who have complex health care needs, chronic illness, disability, and life limiting illness. This population requires a wide range of services, including but not limited to medical coordination, educational needs, and social determinants of health. The CCK Nurse Care Coordinator provides an extended support system for the child and family by coordinating medical, educational, community, and social services to benefit the patient and family and eliminate barriers affecting health by possessing a broad understanding of resources.
PRINCIPAL DUTIES AND RESPONSIBILITIES: Indicate key areas of responsibility, major job duties, special projects and key objectives for this position. These items should be evaluated throughout the year and included in the written annual evaluation.
Clinical
Conduct comprehensive, focused nursing assessments of children and families and create a plan of care with CCK team.
Monitor healthcare services to produce efficiency and cost-effectiveness and avoid duplication.
Demonstrate accountability for evaluation of clinical practice, including adherence to organizational, state, and national practice standards and codes.
Completes assessment of patient and family constellation and creates care plan to facilitate growth and development, improve health care coordination and decrease social barriers.
Documentation in Epic after all communication with patients/families/other care providers
Education
Provide resources for patient education
Act as a health educator and coach, ensuring that family understands all health care and systems issues.
Assist in coordinating educational resources and ensuring parental understanding of IEP, 504 and IHPC
Define goals for professional growth and participate actively in professional activities and organizations.
Community & Care Coordination
Organizes alternative transportation when needed
Act as liaison between patient, family, PCP, specialty providers, and community supports.
Act as a facilitator and child and family advocate within the larger care team.
Assist in organizing large multi-disciplinary teams, clarifying confusing information for families.
Assist families to acquire nursing and patient care services in the home.
Applies for nursing, PCA, or HHA services when warranted.
Refers to outside agencies and community supports for specific patient appropriate resources.
Liaison for state agencies: DDS, DMH, DPH, DESE or others
Act as a resource for community services, e.g., handicapped housing, and liaises with state agencies
Ensure accurate communication for families, including plain language and interpretation when needed.
SKILLS/ABILITIES/COMPETENCIES REQUIRED: Must be realistic, objective, measurable and related to essential functions of this job.
- BLS certification required; PALS certification preferred
- Advanced knowledge of social and community-based programs that address patient health-related social needs
- Social, economic, and cultural awareness.
- Program development and improvement skills
- Data assessment skills
- Must have the ability to be function in a fast-paced environment and manage competing demands effectively and independently, with minimal supervision
- Knowledge of organization policies, procedures and systems
- Knowledge of and dedication to highest customer service standards
- Demonstrated organizational and time management skills.
- Effective interpersonal / communication, organizational, and analytical skills, and the flexibility to handle multiple tasks and deadline pressures are critical.
- Basic PC skills (MS Office, Windows). Prior experience with MGH systems (EPIC, Kronos) helpful but not essential.
EDUCATION: Specify minimum education and clearly indicate if preferred or required
- Bachelor’s Degree in Nursing required.
- Master’s Degree / Degree Candidate in Nursing
LICENSES, CERTIFICATIONS, and/or REGISTRATIONS (if applicable): Specify minimum credentials and clearly indicate if preferred or required
- Current Licensure as a registered nurse in the Commonwealth of Massachusetts
EXPERIENCE: Specify minimum creditable years of experience and clearly indicate if preferred or required
- Minimum of 5 years of pediatric nursing experience.
- Inpatient experience and end of life/palliative care experience preferred.
WORKING CONDITIONS: Describe the conditions in which the work is performed.
- Per diem position with up to 20 hours/week funded through the CCK Sundry
- Work is performed on-site in an office and clinical environment.
Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.
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