Career Center

RN Patient Care Coordinator (Cardiac Surgery)- Heart & Vascular Institute- FT Days

JOB SUMMARY:

Assists in developing and meeting key Pillar outcomes and system improvement goals including financial, satisfaction, and clinical as the nursing component of the care coordination model. This position Improves outcomes by reducing all cause hospital readmissions and coordinating episodes of care among patients in a defined population or disease process. Participates in identification of appropriate patients; encourage patient and family engagement in self-care management; promote warm handovers to the next level of care by providing timely, pertinent information in a standardized way; conduct patient and family education on key elements of the patients' personal care plan by using the "teach-back" methodology and follow up phone calls; and assists the patient in navigating the healthcare system.

Additional Qualification Information

Key Responsibilities

• Coordinates the evaluation process of the defined patient population. May complete and document portions of the evaluation process, collaborating with other team members to ensure completion of all required information.
• Supports patient access by serving as a liaison between the referring provider's office and Vanderbilt provider.
• Interacts routinely and effectively with the clinical team to develop a collaborative plan for the coordination of patient care from the anchor hospitalization through the defined care episode.
• Develops and manages the processes related to pre-admission and post-discharge care transitions; establishes relationships/clinical pathways with providers/agencies to optimize care for defined patient population.
• Assists in the development and dissemination of patient education materials/information to include creation of customized medication grids with input from the pharmacist/team as needed.
• Assists with discharge/transition planning in collaboration with the multi-disciplinary team, actively engaging outpatient care providers by sharing hospital course, concerns, pending test results, learning needs, partnership opportunities etc. Coordinates handovers including outpatient care coordinators (disease management teams), home health care nurses, cardiac rehab, skilled nursing facilities, etc.
• Assists the care team in the outpatient clinic with pre-operative education and coordinates needs during post-operative follow up visits.
• Demonstrates reflective practice by constantly evaluating care coordination and supports the development of protocols for practice based on evidence.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

Core Accountabilities

• Organizational Impact: Delivers projects/assignments that have a direct impact on goals/objectives of the unit/department that the job is in.
• Problem Solving/ Complexity of work: Conducts extensive analysis of situations or data to resolve numerous, complex issues; may involve the input/work of others.
• Breadth of Knowledge: Has in-depth level of knowledge within a professional area and working knowledge of other areas.
• Team Interaction: May lead mid-sized projects; coaches and guides team members.

DEPARTMENT SUMMARY:

Our physicians perform approximately 130,000 clinic visits annually. We offer the most advanced technologies to treat coronary artery disease, arrhythmias, and structural heart disease in new, state-of-the-art cardiac catheterization and electrophysiology laboratories. In 2018, our heart transplant program was the second busiest in the world, with 100 adult heart transplants performed that year. Our multi-disciplinary programs in prevention, lipid management, inherited heart disease, adult congenital heart disease, vascular medicine, and cardio-oncology are unique in the region and among the busiest nationally.

*Relocation Assistance available.

Position Shift:

*Monday- Friday 8am-5pm

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