Care Management Coordinator
2 months ago
We are seeking a highly skilled and experienced Care Management Coordinator to join our team at Fraser Health. As a key member of our interprofessional team, you will play a critical role in facilitating patient flow and ensuring timely and effective discharge planning.
Key Responsibilities- Coordinate care and discharge planning for patients, working closely with the Patient Care Coordinator, physician, and interprofessional team to determine discharge goals.
- Proactively collaborate with the Home Health Liaison team to determine available services and prioritize discharge planning activities based on patient level of need/risk.
- Lead interdisciplinary rounds by facilitating care planning with the healthcare team and other stakeholders.
- Focus team members on developing medical/functional goals as well as discharge plans to ensure a safe, appropriate, and timely discharge.
- Facilitate patient flow activities by identifying patients requiring specialized attention in order to move effectively through the system.
- Coordinate patient transfer to alternate level of care.
- Act as a resource/advisor for referral to services relative to diagnoses and post-discharge care.
- Observe, monitor, and evaluate assigned patient progress, symptoms, and behavioral changes by reviewing patients' daily status, anticipating responses to care, and identifying problems or variances from the expected care plan.
- Intervene to facilitate resolution of problems and removal of barriers.
- Reorganize priorities and collaborate with the physician and interprofessional team to revise care plans as required to ensure that the plan of care and services provided are patient-focused, high quality, efficient, and effective.
- Develop and recommend policies, procedures, and standards to support effective care management and discharge planning.
- Consult and collaborate with physicians and other healthcare professionals/providers in the identification and resolution of a variety of patient care issues.
- Identify and resolve potential barriers to efficient care delivery through collaboration with the Manager, Clinical Operations, Patient Care Coordinator, and the interprofessional team.
- Coordinate and lead case conferences/meetings with patients, family, and service providers for resolution of patient care issues.
- Act as patient advocate to protect and promote the patient's right to privacy, dignity, and access to information and to ensure the patient's choice and autonomy in decision making and care planning.
- Act as a resource to staff, patients, and families regarding care management and discharge planning.
- Current practicing registration as a Registered Nurse with the British Columbia College of Nurses and Midwives (BCCNM).
- Three years recent, related acute care experience, including one year of experience in community care and discharge planning, or an equivalent combination of education, training, and experience.
- Comprehensive knowledge of nursing theory and practice within a patient/family-centered model of care.
- Comprehensive knowledge of the BCCNM Standards of Practice.
- Broad knowledge of evidence-based nursing practice related to various patient population groups and demonstrated ability to apply knowledge to a case management process.
- Ability to apply knowledge of pathophysiology and pharmacology to safely plan discharge.
- Broad knowledge of the illness or disease process and potential long-term complications.
- Broad knowledge of other healthcare disciplines and their role in patient care.
- Broad knowledge of clinical pathways, expected length of stays, resource utilization, and patient assessment.
- Broad knowledge of external agencies and community resources.
- Ability to engage in comprehensive assessment, observation, and monitoring of patients.
- Ability to plan, organize, and prioritize work.
- Ability to analyze situations, problem solve, deal with conflict, and negotiate resolutions in a timely manner.
- Ability to provide leadership and consultation.
- Ability to work independently in an organized and self-directed manner and also as a member of an interprofessional team.
- Ability to communicate effectively both verbally and in writing.
- Ability to operate related equipment, including applicable software.
- Physical ability to perform the duties of the position.
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Care Management Coordinator
1 month ago
Abbotsford, British Columbia, Canada Fraser Health Full timeJob SummaryWe are seeking a highly skilled and experienced Care Management Coordinator to join our team at Fraser Health. As a key member of our interprofessional team, you will play a vital role in facilitating patients' hospitalization from admission through discharge.Key ResponsibilitiesCoordinate and collaborate with the interprofessional team to...
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Care Management Coordinator
2 months ago
Abbotsford, British Columbia, Canada Fraser Health Full timeJob SummaryWe are seeking a highly skilled and experienced Care Management Coordinator to join our team at Fraser Health. As a key member of our interprofessional team, you will play a vital role in facilitating patients' hospitalization from admission through discharge.Key ResponsibilitiesCoordinate and collaborate with the interprofessional team to...
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Care Management Coordinator
2 months ago
Abbotsford, British Columbia, Canada Fraser Health Full timeJob SummaryWe are seeking a highly skilled and experienced Care Management Coordinator to join our team at Fraser Health. As a key member of our interprofessional team, you will play a critical role in facilitating patients' hospitalization from admission through discharge.Key ResponsibilitiesCoordinate and collaborate with the interprofessional team to...
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Care Management Coordinator
2 months ago
Abbotsford, British Columbia, Canada Fraser Health Full timeJob SummaryWe are seeking a highly skilled and experienced Care Management Coordinator to join our team at Fraser Health. As a key member of our interprofessional team, you will play a critical role in facilitating patients' hospitalization from admission through discharge.Key ResponsibilitiesCoordinate and collaborate with the interprofessional team to...
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Care Management Coordinator
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Abbotsford, British Columbia, Canada Fraser Health Full timeJob SummaryWe are seeking a highly skilled and experienced Care Management Coordinator to join our team at Fraser Health. As a key member of our interprofessional team, you will play a critical role in facilitating patients' hospitalization from admission through discharge.Key ResponsibilitiesCoordinate and collaborate with the interprofessional team to...
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