Riverside Health System

  • Outpatient Care Coordinator (RN or Social Worker)

    Location Name Riverside - The Center for Excellence in Aging and Geriatric Health (CEAGH)
    Department Acl Adpi Grant
    Job ID
  • Overview

    Riverside's Center for Excellence in Aging & Geriatric Health (CEAGH) is looking for and experienced RN or Social Worker to join their team! 



    The Outpatient Coordinator works under the supervision of the Care Management Leadership and is responsible for the coordination of care to patients who are considered high risk with complex medical and psycho-social needs. The Outpatient Coordinator strives to promote coordinated care in order to improve outcomes, efficiency in utilization of health care services by performing the following core functions:
    a) Assessment: Identification of patients for case management; comprehensive collection of patient information and medical status; and continued evaluation of an established plan of care b) Planning: Collaboration with the patient, family/caregiver, primary provider, community partners and other members of the health care team for developing an effective plan of care c)
    Facilitation: Care coordination and communication among all involved parties
    d) Advocacy: Support for the patient and family/caregivers to ensure identified education and appropriate, timely care is received. The position requires a high degree of flexibility, independence and willingness to participate in multiple activities with local travel. The Outpatient Coordinator must have strong communication skills and the ability to converse comfortably with patients, caregivers, physicians, community partners and the interdisciplinary team




    Program Graduate of Nursing/Social work required
    Associates Degree-Nursing preferred
    Bachelor's degree nursing/social work preferred or to be obtained in 5 years
    ADN or Diploma in Nursing required; Bachelor's preferred for RN or SW


    Nurse/Social Work-Va or Compact State required
    CPR/BLS required
    Driver's license in good standing-VA required
    Case Management Certification preferred
    5 years-required
    5 years Nursing/SW experience in acute care setting or long term care Required
    Prior Care Management Experience Preferred
    Health insurance and medical management experience
    Knowledge of current Medicare and Medicaid regulations
    Previous experience in Home Health, Utilization Management, Discharge Planning• Disease Management or Health Coaching


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