• The Clinical Nurse Coordinator supports the mission of the Community Practice Center (CPC) to improve health outcomes by focusing attention on groups of patients as well as individual patients identified as having or likely to have gaps in care, adverse health outcomes, or suffer from health inequities related to social, racial/ethnic, environmental, and economic determinants of health.
• This position reviews and monitors data sets such as care gap reports by population, internal health registry reports, missed opportunities for prevention, and follow up of transition in care.
• The Clinical Nurse Coordinator works in collaboration and continuous partnership with chronically ill or high-risk patients and their family/caregiver(s), clinic/hospital/specialty providers and staff, and community resources in a team approach to promote timely access to appropriate care, increase utilization of preventative care; reduce emergency room utilization and hospital readmissions.
• The Clinical Nurse Coordinator will help to create and promote adherence to a care plan, developed in coordination with the patient, primary care provider, and family/caregiver(s); increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals; provide medication reconciliation; ensure prior authorizations are completed timely; connect patients to relevant community resources, with the goal of enhancing patient health and well-being; focus on increasing patient satisfaction and reducing health care costs.
• This position collaborates with physicians, providers, licensed social workers and community health worker to assist in coordination of patient care. .
• Along with the operations manager, this position works directly with health plan representatives to ensure that patient attribution lists are timely and up to date and that quality measures are documented, monitored, and reported.
• Success in this position will lead to improved health for the patient and reduced health care costs for the managed population of patients.

Einstein Healthcare Network is a private, not for profit organization with several major facilities and many outpatient centers. Our primary mission is to provide compassionate, high quality healthcare to the greater Philadelphia region.

• Minimum BSN or bachelor’s degree in nursing.
• Prior experience in population health, quality improvement, or care coordination preferred.
• Minimum 5 years of experience as a RN, 2 of which must include caring for adult, preferably geriatric-aged patients with chronic diseases such as diabetes, hypertension, hyperlipidemia.
• Some supervisory experience preferred.
• Prior experience with use of electronic health record systems required.
• Prior experience in telehealth care preferred.
• Proficiency with Microsoft Office products, specifically Excel, required.
• Ability to work independently and meet deadlines.
• Excellent oral and written skills are required.
• This position is highly involved with Department leadership, staff, providers, clients, colleagues, outside vendors and the community.