Nurse Care Coordinator

Position Description

Employees in this classification are registered nurses responsible for helping manage a patient's care by coordinating the patient's treatment plans, educating them about their condition, connecting them with health care providers, and evaluating their progress. The incumbent will be responsible for consulting with patients, family members, and the health care team to determine patient needs, develop care plans, coordinate patient services, develop expected patient outcomes, and work with the care team to evaluate interventions. Requires a high degree of contact with patients, families, and TTUHSC clinic staff.

A Transitional care management (TCM) nurse coordinates a patient's care as they move between healthcare settings, such as from hospital to home, to prevent complications, hospital readmissions, and improve health outcomes. The overall goal is to ensure a seamless transition, enhance the continuity of care, and empower patients to manage their health effectively.

Major / Essential Functions

• Identifying high-risk patients.
• Conducting post-discharge follow-up calls and visits within specific timeframes and using clinic protocols.
• Reconciles the discharge medication list.
• Provides education to patients and caregivers, along with implementing teaching plans for patients and their families with health learning needs.
• Promotes and reinforces patient-centered medical home concepts with patients, their family, and clinic personnel.
• Works proactively to prevent complications, reduce hospital readmissions, and manage patient populations by identifying and addressing quality gaps in care needs.
• Audits charts utilizing custom report data, identifies and reports alterations in patient responses to assist in the identification of problems and formulation of goals / outcomes and patient-centered plans of care in collaboration with patients, their families, and the interdisciplinary health care team.
• Assists in determining the physical and mental health status, needs, and preferences of culturally, ethnically, and socially diverse patients and their families.
• Communicates patient data using EMR to support decision-making to improve patient care.
• Participates in the identification of patient needs for referral to resources and facilitates continuity of care.
• Completes Annual Nursing Core Competency Training and maintains current nurse licensure.

Preferred Qualifications

Pay Statement

Compensation is commensurate upon the qualifications of the individual selected and budgetary guidelines of the hiring department, as well as the institutional pay plan. For additional information, please reference the institutional pay plan website at

EEO Statement

All qualified applicants will be considered for employment without regard to sex, race, color, national origin, religion, age, disability, protected veteran status, or genetic information.

Required Qualifications

Graduated from an approved, accredited nursing program. A minimum of 2 years of experience in a clinical or community resource setting; Care coordination and / or case management experience is desirable. Current RN license in the State of Texas or ability to attain a temporary permit from the Board of Nursing to practice nursing pending full licensure in the state of Texas.

Jeanne Clery Act

The Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act is a federal statute requiring colleges and universities participating in federal financial aid programs to maintain and disclose campus crime statistics and security information. By October 1 of each year, institutions must publish and distribute their Annual Campus Security Policy & Crime Statistics Report (ASR) to current and prospective students and employees. To view this report, visit the TTUHSC Clery Act website at

Introduction

Nationally recognized as a Great College to Work For, TTUHSC provides much more than just a job! Enjoy excellent benefits, including paid leave, retirement plans, wellness programs, health insurance, and so much more. Ready to start building a rewarding career in a positive environment where you can develop and thrive? Join us as we change the future of health care.

About TTUHSC

Texas Tech University Health Sciences Center is enriching the lives of others by educating students, providing excellent patient care, and advancing knowledge through innovative research. TTUHSC graduates more health care professionals than any other health care institution in the state, conferring 24.2% of all degrees and certificates awarded from health-related institutions in Texas. By providing comprehensive clinical services to more than 10 million individuals across 121 counties, TTUHSC is dedicated to advancing the health of people throughout Texas and beyond. This is where world-class education meets compassionate patient care - and we believe that our people are the reason for our institution's lasting success and bright future.

Being part of the TTUHSC team means being part of an innovative and supportive community that empowers each individual to do their best work. Through our values-based culture, TTUHSC is committed to cultivating an exceptional workplace community with a positive culture that puts people first.

Benefits

TTUHSC is committed to creating an environment where our team members can do their best work, with programs and benefits to support head-to-toe well-being. Explore just a few of the advantages of being a TTUHSC team member :

Additionally, TTUHSC invests in the success of our team members by providing opportunities for personal and professional growth, including lifelong learning programs, recognition programs, and health and wellness initiatives. Team members also enjoy a variety of other perks, such as special membership rates at local gyms and golf courses, access to state-of-the-art software and facilities, and discounts on travel, technology, entertainment and more.