Care Coordinator - Population Health
Loyola University Health System

Job Info

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Employment Type:
Full time
Shift:
Day Shift

Description:

** The Care Coordinator position requires a current RN license.**

This is not a remote position.
Come join our dedicated and dynamic team providing care coordination for LUHS patients as they transition through acute inpatient to the post - acute (SNF/AIR) care and ultimately back home. You will utilize current nursing practices to provide patient care while focusing on the needs of the patient and
exemplifying the service excellence goals of care, concern, respect and cooperation. As a contributing member of a health care team you will develop and provide a comprehensive plan of care for assigned patients while they are in SNF/AIR care and as they transition home.

Provide comprehensive and individualized access to physical health,
behavioral health, and supportive community and social services,
ensuring patients receive the right care in the right setting at the right
time. Empower patients and their families/caregivers to be active
participants in their care, through patient-friendly education and
informed shared decision-making that is based on cooperation, trust,
and respect for each individual's health care knowledge and health
literacy, values, beliefs, and cultural background. Encourage patient
self-management.

Coordinate the plan of care with SNF/AIR facility staff and the patient and family to ensure rehabilitation goals are met and transition to next level of care is safe and smooth. Ensure accountability for coordinating,
providing, and monitoring a patient's/family's needs, including
prevention, wellness, medical and behavioral health treatment, care
transitions, and access to social and community services through the
creation of an appropriate individual plan of care that meets the needs of
the patient and the family.

Utilize population-based tools to support and monitor wellness and care
goals for each patient, aimed at preventing illness and improving
individual well-being, clinical outcomes and quality of life while
managing multiple chronic illness conditions. Interface with providers
across the continuum of care via face-to-face interaction, phone
conversations, email, fax and text messaging.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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