Care Coordinator, RN Full-Time

Job Summary:

The Care Coordinator is responsible for supporting patient care coordination and case management activities across the continuum of care. This role ensures patients receive appropriate services and resources to promote safe, efficient, and effective care transitions. The Care Coordinator facilitates planning, communication, and collaboration among healthcare teams, payers, and community resources, while promoting compliance with regulatory standards and organizational policies. Key responsibilities include conducting assessments, developing, and implementing care plans, coordinating services, monitoring progress, and addressing barriers to care. The position also supports utilization review processes, participates in quality improvement initiatives, and ensures adherence to accreditation guidelines and applicable Federal and State regulations. 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Delivers nursing care according to the standards of care defined within the Illinois Nurse Practice Act.
• Perform comprehensive patient assessments, including medical, psychosocial, and legal needs, through direct interaction, record review, and collaboration with caregivers and support systems. 
• Develop individualized care plans with measurable goals and timeframes for all age groups (infants through geriatric). 
• Implement and coordinate case management intervention, ensuring integration of resources and communication with physicians, payers, and community agencies. 
• Collaborate with healthcare providers to formulate care plans and provide patient education. 
• Monitor and evaluate care plans for effectiveness; modify as needed based on patient outcomes. 
• Facilitate multidisciplinary team meetings and ensure continuity of care across settings (inpatient, outpatient, skilled, long-term care, home health, hospice).
• Provide education on benefits, coverage, and public programs (Medicare, Medicaid, SSI, SSDI). 
• Set up and coordinate Durable Medical Equipment (DME) needs for patients, including timely ordering and delivery to support discharge planning and continuity of care. 
• Audit patient charts for completeness and accuracy, ensuring all clinical, regulatory, and documentation requirements are met. 
• Prepare and complete all required documentation for Utilization Review daily to maintain compliance and support reimbursement processes. 
• Interact with managed care organizations, implement cost-containment strategies, and conduct utilization review activities. 
• Address psychosocial needs, cultural considerations, and family dynamics; assist with advanced directives and referrals.
• Participate in process improvement initiatives to enhance care delivery and patient satisfaction.
• Conduct follow-up evaluations across the continuum of care to identify clinical, operational, and financial issues impacting outcomes. 
• Maintain an organized work environment and demonstrate ability to work remotely for a portion of duties, if needed.
• Communicate effectively with patients, families, and staff across all age groups.
• Respecting cultural, emotional, and spiritual needs of patients, always preserving dignity.

Professional Requirements:

• Supports and promotes an environment conducive with the Mission, Vision, and Values of the hospital.
• Demonstrate collaborative approach and ability to influence clinical practice, gain cooperation, and facilitate change with physicians, clinical staff, and hospital leaders. 
• Demonstrate expertise in professionalism.
• Proficient verbal, written and critical thinking skills.
• Maintain emotional maturity, professional appearance, and adherence to universal precautions.
• Demonstrate accountability, accuracy, and thoroughness in all tasks.
• Exhibit strong organizational skills, problem-solving ability, and initiative. 
• Ensure compliance with hospital policies, safety standards, and infection control practices.
• Maintain confidentiality of patient, hospital, and physician information.
• Adapt to reassignment and work under time constraints with minimal supervision.
• Stay current in case management practices and nursing standards.
• Display genuine concern for the patient population served.
• Completes and maintains all required education and/or training requirements.
• Comply with HIPAA regulations and always maintain patient confidentiality.
• Follows and maintains all lawful safety, health requirements, and regulations, and follows protocols for required protective equipment (PPE).
• Promptly reports safety issues, job-related injury, or illness, near misses, etc. in SafetyZone.
• Follows Hillsboro Health Standards of Behavior.

Education and/or Experience:

• Bachelor’s degree preferred. 
• 2 to 5 years of recent clinical experience required. 
• Experience in Case Management and Utilization Review preferred. 
• Knowledge of computers, financial and reimbursement issues are helpful. 

Certificates and Licenses:

• Registered Nurse currently licensed in the state of Illinois. 
• Basic Life Support (BLS) required or willing to obtain within 30 days of hire. 
• Case Management Certification preferred or willing to obtain. 
• ACLS and PALS are optional, not required.

Physical Demands:

Physical demands of the position, including vision, hearing, repetitive motion, and environment are required. A separate document will be provided upon hire, during annual evaluation process, and upon request. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.

CORPORATE COMPLIANCE

Receives training and/or attends necessary meetings to meet the criteria as outlined in Hillsboro Health’s Corporate Compliance Plan and Code of Conduct. Understands the responsibilities related to compliance and knows whether to contact the Corporate Compliance Officer should there be any instance of question or concern regarding fraud and/or abuse.