RN Care Coordinator – Outpatient Brain Tumor Center

RN Care Coordinator – Outpatient Brain Tumor Center

Requirements

• Graduate from an accredited school of Professional Nursing
• Current state licensure as a Registered Nurse (RN)
• Basic Life Support (BLS) Certification through the American Heart Association (AHA)
• Three to five years of nursing experience

Responsibilities

• Identify patients in the specialty care practice who require ongoing care coordination for their condition.
• Outline the nature and duration of involvement needed by the specialty care team and coordinator; identify the primary care team involved.
• Utilize assessment skills and risk tools to determine actual or potential care needs; conduct comprehensive clinical assessments covering medical, behavioral, pharmacy, social, and end-of-life needs.
• Conduct targeted outreach to high-risk patients (e.g., chronic illness, limited social support, frequent ED visits, readmissions, surgical episodes) to ensure timely and efficient care delivery.
• Use technological tools (registries, patient lists, care team tab, etc.) to manage patient populations and monitor compliance with the plan of care.
• Inform and educate patients and families about care coordination and disease management; assess health literacy, knowledge, and readiness to change using teach-back methods.
• Coach patients and families on self-management support, including setting short- and long-term goals, and provide education on managing specialty or surgical conditions across the continuum (preoperative, perioperative, postoperative, recovery).
• Collaborate with the interdisciplinary team to develop care goals, plan interventions, and perform reassessments; update care plans based on patient progress.
• Ensure care gaps are closed for chronic diseases, specialty conditions, and surgical episodes.
• Serve as the primary patient contact and coordinate care team members to facilitate access to services.
• Act as a liaison between patients, families, and healthcare providers; advocate for patients and resolve concerns.
• Assist in managing care transitions across settings by ensuring effective communication, identifying barriers, and facilitating solutions.

Preferred Qualifications

• Bachelor’s of Science in Nursing (BSN)
• Specialty certification