The Permanente Medical Group, Inc. (Kaiser Permanente Northern California)
Berkeley, California
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Responsible for managing, coordinating and integrating all Care Coordination services within CHRISTUS St. Vincent Health System. Provides Care Coordination services to patients based on person-centered acuity and coordinates patient in hospital or clinic setting. Contributes to a cooperative and accountable working relationship with other members of the Care Coordination system staff toward the goal of providing continuous high quality services to patients. Promotes optimal person-centered care that supports and empowers individuals, respects individual choices and meets health care needs of patients. Works side-by-side with clinical leaders in the development and implementation of protocols. May work in traditional clinic setting and/or in a training environment (residency program) or other areas as assigned.
Responsibilities:
Provides Care Coordination services in the ambulatory setting that supports quality patient care across the continuum.
Ability to work in a variety of electronic medical records, ability to compile record information into a single patient file. Inputs patient orders from standing protocols and displays above average critical thinking skills.
Maintains coordination of health care for patients within CSVCG; routinely interacts with physicians, administrators, managers, care coordinators and patients to ensure an integrated continuum of person-centered services and programs.
Communicates in such a way to promote harmonious interpersonal relationships within and among all settings of care.
Develops relationships with a variety of community resources to include Skilled Nursing Facility (SNF), rehab, Long Term Acute Care (LTAC), home health, hospice, palliative care, and other essential community support agencies. Maintains good working knowledge of services provided by these entities.
Works closely with the interdisciplinary team and providers to ensure appropriate referrals, follow-up and optimal patient outcomes over time. Is able to close the loop on referrals and any pending patient care needs efficiently.
Exhibits behaviors and actions which create a high level of patient satisfaction, contributes to positive patient relations and reflects respect for a patient?s rights, needs and confidentiality.
Participates and can lead pertinent groups (such as interdisciplinary teams).
Tracks, analyzes and interprets patient satisfaction, outcome measure and individual patient treatment plans.
Requirements:
Education:
Registered Nurse, BSN in Nursing, preferred.
Certification/Licenses:
Current New Mexico Nursing License
Skills:
Considerable knowledge of health care facilities, policies and issues, and of the full spectrum of community patient care services
Considerable knowledge of health care and social management principles
Ability to coordinate various functions and activities for maximum cooperation and integration of services providers and persons receiving care within a clinic for continuum of care services
Ability to direct, instruct and advise staff, and to receive and effectively react to day-to-day problems
Ability to utilize strong communication skills, both written and oral, and effectively demonstrate an interactive style of care coordination
Ability to understand and implement sensitivity and culture of care measures appropriate to a diverse population
Ability to work with various levels of the CHRISTUS organization including clinical, financial, administrative and medical staff.
Experiene:
Minimum of two years of experience in a health care setting and related experience with quality, care coordination and population health preferred.
CHRISTUS Health is an international faith-based, not-for-profit health care system based in Irving, Texas, with more than 60 hospitals in Texas, Louisiana, New Mexico, Chile, Colombia and Mexico. CHRISTUS Health is made up of 50,000 Associates providing compassionate and individualized care at more than 600 centers, including community hospitals, clinics, long-term care facilities and health ministries. Sponsored by the Sisters of Charity of the Incarnate Word of Houston, Sisters of Charity of the Incarnate Word of San Antonio and the Sisters of the Holy Family of Nazareth, our mission is to extend the healing ministry of Jesus Christ to every individual we serve.