Job Summary and Responsibilities
As a RN Care Coordinator, you will be a central figure in patient care, seamlessly navigating the healthcare journey to achieve optimal outcomes and an exceptional patient experience.

Every day, you will strategically assess, plan, and facilitate comprehensive care across the continuum, expertly advocating for patients while collaborating with physicians, nursing, departments, insurers, and post-acute providers to ensure timely, high-quality transitions.

To be successful in this role, you will possess strong clinical acumen, exceptional communication and advocacy skills, and a strategic mindset, all driven by a passion for optimizing patient care across every touchpoint.
Completes and documents a discharge planning assessment on those patients identified by the designated screening process, or upon request. Reassess the patient as appropriate and update the plan accordingly.Facilitates the development of a multidisciplinary discharge plan, engaging other relevant health team members, the patient and/or patient representative and post acute care providers in accordance with the patients clinical or psychosocial needs, choices and available resources.Oversees and evaluates the implementation of the discharge plan.Collaborates with the multidisciplinary team to ensure progression of care and appropriate utilization of inpatient resources using established evidence based guidelines/criteria.Collaborates with the healthcare team and post-acute service providers to ensure timely and smooth transitions to the most appropriate type and setting of post-acute services based upon patients clinical needs.Identifies risk for readmission and implements interventions to mitigate those risks for at least a 30-day period.
Job Requirements
RequiredGraduate of an accredited school of nursing and Minimum two (2) years of acute hospital clinical experience, upon hire orMasters Other Case Management or Nursing field. and 1 year of experience, upon hire andRegistered Nurse: TX, upon hire andBasic Life Support - CPR, within 90 Days and
PreferredBachelors Of Science Nursing and At least five (5) years of nursing experience., upon hireCertified Case Manager, upon hire andAccredited Case Manager, upon hire Where You'll Work
St. Luke's Health–Sugar Land Hospital offers the latest technology and treatments for residents of Fort Bend County and Southwest Houston. Our services range from heart care and neuroscience to robotic surgery. Our recently opened Family Birthing Center offers incomparable care and amenities in a spa-like environment to provide a VIP—Very Important Pregnancy—experience. Since 2008, our experienced doctors, nurses, and support staff have provided expert care to support our community.

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.