RN Clinical Care Coordinator

Position Overview

The RN Clinical Care Coordinator is responsible for the clinical care coordination of ALWP clients under the Care Coordination Agency (CCA). In this role, you will assist waiver recipients in accessing waiver services, state plan services, and other community resources, as well as act as the clinical resource for the CCT Program. Salary: $90,000 - $105,000 PER YR. This position reports to Lead RN Clinical Care Coordinator and involves working both remotely and in the field.

Key Responsibilities

• Responsible for the proper completion of all clinical documents required for the State Waiver Program Application as per ALWP and Agency policy.
• Conducts assessments using the ALW Assessment Tool to determine each client’s level of care.
• Develops Individualized Service Plans (ISPs) using the ALW ISP Form and modifies them as needed.
• Monitors service delivery by adhering to the prescribed schedule of client contact through face-to-face or telehealth visits (with prior supervisor approval) on a monthly basis and as needed.
• Maintains proper charting, progress notes, and case records for each enrolled client.
• Manages complaints from clients, families, or friends.
• Reports all signs of abuse or neglect to the appropriate agencies based on the setting (DHCS and the Ombudsman for RCFE, or DHCS and APS for PH).
• Attends Case Conferences with RCFE’s monthly, or as needed.
• Evaluates ISP effectiveness through observations of clients’ physical condition, behavior, signs and symptoms of illness, reactions to treatment, and communications with clients and health team members.
• Reviews Significant Incident Reports (SIRs) with clients and RCFE staff as necessary.
• Provides clinical support for the CCA Office Coordinators.
• Participates in education, training, and quality improvement activities for ALWP while ensuring compliance with Federal, State, Local, HIPAA, or Joint Commission Standards.
• Establishes and maintains good relationships with RCFE, SNFs, and other vendors.
• Regularly self-assesses nursing skills and educational needs to meet the care requirements of assigned patients.
• May be required to drive to geographical areas covered by the company.
• Maintains a comfortable work environment, proper timekeeping, and adherence to policies and procedures as outlined in the Employee Handbook.
• Ensures all required credentials are maintained up-to-date, reports fraud and abuse, and follows mandated reporting procedures.
• Conducts timely documentation of all client contact and attends department meetings and state-mandated in-service trainings.
• Maintains familiarity with Title 22 and performs other duties as assigned.

Required Qualifications

• Must have a current, unsuspended, un-revoked license to practice as a Registered Nurse in California.
• Possess knowledge of the California Assisted Living Waiver Care Coordination Agency Provider Handbook, RCFE Provider Handbook, and the clinical requirements of the CCT and ALWP transition process.
• Understand the current Nursing Practice Act, including its implementation as outlined in the California Business and Professions Code and the California Code of Regulations.
• Possess current CPR certification.
• Be proficient in the use of computers.
• Have a minimum of two (2) years’ experience in a home health organization, primary care clinic, or health facility; one (1) year experience in healthcare quality management is preferred.
• Provide a current and satisfactory report on a pre-employment physical examination, including TB Screening Test or chest X-ray as required by agency policies, and be free from signs of infection or illness.
• Exercise excellent judgment with demonstrated clinical, analytical, and documentation skills.
• Exhibit strong written and verbal communication skills and be fluent in English.
• Be a licensed driver with a properly insured and well-maintained automobile, in compliance with state and/or organizational requirements.