The Care Coordinator-RN (CCRN), as a part of the primary care patient centered medical home team, engages in a collaborative process, which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet a member's health needs through communication and available resources to promote quality, cost effective outcomes. This process will be applied in various settings to include acute care, skilled nursing care settings, long term acute care settings, rehab facilities, custodial care, in ambulatory settings and in member's home. The CCRN functions as a member of a multidisciplinary team, which includes a Navigator, Care Coordinator-Social Worker (CCSW), Pharmacist and Nurse Practitioner.
Scope of Position The CCRN reports to the Clinical Director, Non-SNP Care Coordination, and is responsible for the management of an assigned population of members as part of the patient centered medical home model. The CCRN will also have responsibilities to maintain and ensure alignment with the mission of Peoples Health as outlined in the Mission Statement.
As part of a multidisciplinary care coordination team, the principal responsibilities are:
Participates in regional team meetings to improve member's outcomes and Peoples Health processes.
Peoples Health Competencies
Every employee is expected to meet Peoples Health minimum requirements: