To serve as a patient advocate and coordinator throughout the continuum of care related to the management of patient centric heart failure care. The Heart Failure Program Coordinator will work collaboratively with multidisciplinary teams towards reducing Heart Failure (HF) 30 day readmissions and ER visitations through programs modeled and structured around the Medicaid Waiver Project (MWP) Heart Failure Transitional Care Management (TCM). The Heart Failure Program Coordinator works collaboratively with all disciplines to include administration, leadership, physicians, APP's, care coordinators, CDI and coding specialists, clinical data analyst, community resources and other health care providers to facilitate cost-effective, care coordination. Utilize the Triple Aim Framework as a guide to reach quality standards, and concepts throughout the HF program activities which focus on improving the patient's experience of care, population health and reducing per capita cost of health care.
Medicaid Waiver Project HF Care Transitions Project
- Will be co-responsible for all the operational aspects, performance outcomes related to the QPI requirements of the project
- Close monitoring of the CAT 3 performance of the hospital system
- Accountable for the collection, custodianship and reporting of specific patient data points related to the project
- Main access point for MWP patients via phone, both inpatient and outpatient basis.
- Measurable outcomes that are cost effective and reflect patient preferences and values.
Function as the Access Point and Primary Resource for a broad spectrum of Heart Failure activities, information, education, guidelines and communication throughout the system related to both inpatient and outpatient Heart Failure care. Assists in the development and ongoing management of care guidelines, protocols, education materials, collection and analysis of performance data for patient safety, quality assurance and improvement so that clinical outcomes and quality metrics are achieved. Available for special projects and focus groups related to the enhancement, advancement and extension of Heart Failure care within our system, throughout the community and region. Drives quality, outcomes and best practices leading, obtaining and sustaining Heart Failure accreditation.
TX RN license
3 years Cardiac bedside experience
Able to use computer, keyboard and mouse proficiently
BCLS American Heart Association
Knowledge of health promotion/behavior modification preferred
Experience in using electronic medical record systems
Outstanding interpersonal and leadership skills to interact with persons at all levels
Presentation, negotiation, and conflict resolution skills
Excellent written and verbal communication skills
Must have excellent customer service skills
Must obtain Heart Failure Specialty Certification(CHFN)
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.