Job Description

Northwest Medical Center is comprised of a 300-bed  hospital, four urgent care facilities, a freestanding emergency center and a large physician group, offering you a variety of settings in which to work.  Every location is dedicated to providing safe, quality patient care, but more than that is the commitment to employees.  It strives to provide a culture of teamwork, respect and appreciation for all staff, whether they care for patients directly or work in a support role. With employee appreciation celebrations throughout the year, opportunities for growth and the satisfaction that you are part of a hospital leading the way with accessible, convenient healthcare in Tucson, Northwest is a great place to work.  NMC is accredited by The Joint Commission and is an equal opportunity employer:  race, gender, disability and Veteran status, and VEVRAA Federal Contractor - priority referral Protected Veterans requested.

This is a full-time position working the day shift at Northwest Medical Center

Position Purpose:

The Continuum of Care Coordinator (CCC) is responsible for improving a patient's level of wellness, reducing unnecessary readmissions and ensuring appropriate utilization of in-network healthcare resources.  The CCC will collaborate with Leadership and Case Management to review trends. Works in a medical setting with physician practices, hospital teams, PAC providers and the ACO to manage the full continuum of care in the provider network. Establish and maintain a Post-Acute Preferred Provider network in conjunction with CHS/ACO regulations and bylaws. Review patient care concerns and identify resolution of issues to meet patient care needs. Review Readmissions Rates and Readmission Retention rates of Post-Acute Providers and initiate discussions with those providers to seek improvements in performance.  Review PAC utilization to include ALOS, RUG levels, ED visits, and multiple PAC transfers.


Position Qualifications:
Required: Degree in Nursing or Social Work
Preferred: Bachelor's degree
Required: Two (2) years of strong clinical healthcare experience. Current working knowledge of discharge planning, utilization management, case management, and disease management. Understanding of pre-acute and post- acute venues of care and post-acute community resources, physician office routines, and transitional procedures for pre and post-acute care.
Preferred: Supervisor or project leadership. Knowledge of Medicare, and ACO practice management. Prior experience as a Care Navigator for high-risk patient populations.
Demonstrated ability to communicate effectively in person and via telephone with patients, families/caregivers, physician office staff, and Post-Acute providers using appropriate dialogue and customer service competencies. Can aggregate and evaluate patient level data focusing on medical, psychosocial, and the education needs utilizing established post-acute criteria. Ability to perform multiple activities, meet deadlines, solve problems, utilize resources, make independent decisions, and work well in a team-based environment
Required: Current Arizona RN license or compact state license OR Social Work Licensure (LCSW) and American Heart Association BLS.

Application Instructions

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