Liberty Resources is a dynamic and growing human services agency that is a great place to work! Our employees have passion around the services they provide and our corporate values of excellence and staff support. We pride ourselves on high quality, integrated, community-based services that meet the evolving needs of our communities.

Liberty Resources is seeking applicants for the position of Registered Nurse (RN) Care Coordinator for Liberty Resources Integrated Health Care in Syracuse, NY. Liberty Resources Integrated Health Care is a Certified Community Behavioral Health Center in Syracuse, serving children, families and adults with behavioral health challenges including co-occurring substance abuse.

Our employees have passion around the services they provide and our corporate values of excellence and staff support. We’re committed to building a diverse workforce that values contributions of all team members and work to recognize cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and how they apply to provision of positive health outcomes.

Position Summary:

The Registered Nurse (RN) Care Coordinator will function as a member of the Integrated Health Care Clinical Team. Under the supervision of the Nurse Manager or designated Nurse Leader, the RN Care Coordinator will be responsible for patient assessments and care plans, including physical health, social determinants of health, behavioral health, health literacy, and more. The RN Care Coordinator will be responsible for coordinating patient care within the Integrated Health Center and with external agencies, ensuring that patients receive the appropriate services and support to manage their health conditions effectively. The RN Care Coordinator serves as a liaison between patients, families, healthcare providers, and community resources to promote high-quality, cost-effective care and improve health outcomes. The RN Care Coordinator will function within the scope of practice of their license and community standards of care.

Job Responsibilities:

Perform intake and annual assessments for new and established patients.
Manages the patient assessment effort regarding data collection, monitoring compliance, trending and tracking, and contributes to workflow improvement as it relates to patient assessments and ongoing health monitoring.
Ensures the provision of all health-related services and directs and supervises other nursing staff as needed. This includes conducting health monitoring services and comprehensive nursing assessments for clients, and the timely and appropriate documentation of such services.
Develops a comprehensive care plan to assist clients in meeting identified health goals, provides direction to staff in support of achieving the care plan, and enhances patient safety per program guidelines. Monitor patients’ progress towards goals, track outcomes, and adjust care plans as needed to ensure effective treatment and patient safety.
Serve as support for patients and the interdisciplinary team, providing patient education on disease management, medications, treatment plans, and available resources, and communicating patient progress and barriers with the team.
Identify and address barriers to care, including social determinants of health, to support patient well-being.
Advocate for patients’ needs and preferences while ensuring compliance with clinical guidelines and organizational policies.
Participate in quality improvement initiatives and support efforts to meet organizational goals related to patient care, safety, and satisfaction.
Responds to staff and client mental and physical health emergencies/crises at the clinic. Provides medical crisis intervention as needed.
Provides education and training to clients and staff on health-related topics like preventative care, infection control, crisis management, medication management and other health topics as needed.
Communicates and consults with medical practitioners, Agency supervisors and other professionals regarding client’s conditions, communicable diseases, responses and needs to promote ongoing management of the client’s health needs and within specified policy timeframes.
Coordinates services with other disciplines, agencies, and providers to meet client's needs in an efficient and cost-effective manner. This may include activities such as managing prior authorizations and managing incoming and outgoing communications with outside agencies.

Completes all necessary written reports, statistics, case files and summaries in a timely manner and in accordance with program and agency standards. Assists in maintaining accurate communication and information transfer with health care providers in the community.
Values service, excellence, and responsibility, seeing opportunity where others see barriers to success. Stiving to create and sustain an inclusive environment where everyone feels a strong sense of belonging.
Performs other duties, responsibilities and related tasks as assigned.

Qualifications

Must be licensed as a Registered Nurse and currently registered to practice nursing in New York State. Must have graduated from an accredited college or school of nursing. Must possess a Bachelor’s Degree or higher and have three years of professional clinical nursing experience, with at least one year of experience providing care to individuals diagnosed with mental illness, or alcohol or substance abuse. Care coordination/case management experience strongly preferred. Must possess a valid driver’s license and access to reliable transportation. Must have eligibility for full and unconditional participation in the Medicare and Medicaid programs. Strong organizational and interpersonal skills. Effective oral and written communication skills. Ability to work independently and with flexibility in days and hours of work. Physical agility with repetitive occurrence including but not limited to: Walking, running, bending, stooping, and climbing stairs, kneeling, crouching, reaching, sitting and twisting. May require lifting greater than 50 lbs. on an as needed basis.

Salary range: $90,000 to $92,000 annually.

Liberty Resources Clinics are approved sites for the National Health Service Corps Loan Repayment Program (Tier 3). Psychiatrists and NPPs are eligible to apply to this program.

Liberty Resources is committed to creating a diverse inclusive environment and is proud to be an equal opportunity employer. Liberty Resources offers equal employment opportunities to all persons without regard to race, color, ethnicity, religion, sex, sexual orientation, national origin, age, marital status, physical or mental disability, parental status, housing status, source of income or military status, in accordance with applicable federal, state and local EEO laws.

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