Working in collaboration with the patient's care team, the RN Clinical Care Coordinator is responsible for coordinating and integrating high quality, cost effective care delivered to patients across an episode of illness or throughout the entire continuum of health care delivery. The RN Clinical Care Coordinator will adopt ColumbiaDoctors' care coordination process and workflow to achieve improved health outcome of populations.
Develop a thorough understanding and adhere to ColumbiaDoctors' Care Coordination and Care Management processes and work flow
Provide education on disease process, medications and self-management methods to patients and/or their caregivers with high clinical acuity and barriers to care
Conduct comprehensive post-discharge assessments for hospitalized patients and provide interventions to reduce complications and readmissions
Outreach to patients who frequent the Emergency Room for avoidable visits, and provide additional self-management support and educate them on alternatives such as same day physician appointments and urgent care facilities
Develop detailed care plans for patients based on assessment of patient's condition, clinical needs, social support and barriers
Connect patients and caregivers to internal and external health care and social services to improve overall health and social outcomes
Increase overall compliance with medical appointments and routine screenings and improve medication adherence
Document in patients' medical records and other data systems to ensure effective data collection and evaluation according to ColumbiaDoctors Care Coordination and Management Standards
Requires a bachelor's degree or equivalent in education and experience, plus five years of related experience
New York State license to practice as a registered nurse or nurse practitioner
Must have experience in patient care coordination (ideally greater than 2 years)
Spanish language fluency required
Performs all other duties as required by the department and institution
Flexibility, tolerance and demonstrate ability to take initiative and to prioritize multiple tasks with attention to details.
Function at a fast pace and able to interact with a wide variety of people and situations while maintaining patient centered focus.
Aware of scope of practice boundaries, comfortable seeking direction and assistance from appropriate resources.
Excellent organization and communication skills with patient care provided in a way that patients are willing to accept.
Proficient in Microsoft Office Suite
Experienced user of an Electronic Medical Record (Allscripts, EPIC preferred)
Equal Opportunity Employer / Disability / Veteran
Columbia University is committed to the hiring of qualified local residents.
Internal Number: 498951
About Columbia University
Columbia University is one of the world's most important centers of research and at the same time a distinctive and distinguished learning environment for undergraduates and graduate students in many scholarly and professional fields. The University recognizes the importance of its location in New York City and seeks to link its research and teaching to the vast resources of a great metropolis. It seeks to attract a diverse and international faculty and student body, to support research and teaching on global issues, and to create academic relationships with many countries and regions. It expects all areas of the university to advance knowledge and learning at the highest level and to convey the products of its efforts to the world.