Join Cleveland Clinic's Main Campus where research and surgery are advanced, technology is leading-edge, patient care is world class and caregivers are family. Here, you will work alongside a passionate and dedicated team, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world. The Center for Spine Health offers a wide range of treatment options including medical, interventional, and surgical depending on the need of the patient. Our specialists are nationally recognized in orthopaedic surgery, neurosurgery and medical spine and work as a multi-disciplinary team to provide comprehensive care to patients. As an RN Care Coordinator, you will be supporting the Walker Center and all procedures in the Spine and Pain Center. You will work collaboratively with multidisciplinary care team staff across the continuum of care to support high-risk patients and provide care coordination and disease management for patients with chronic conditions or those receiving surgical care. Your focus will be on patient outreach and ongoing coordination for a panel of patients to achieve optimal health outcomes, promote wellness, reduce hospital readmissions, ensure they have the correct care plans and enhance overall patient satisfaction. **A caregiver in this role works a hybrid schedule from 8:00 a.m. - 5:00 p.m.** A caregiver who excels in this role will: + 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, re-admissions, 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 providing 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. Minimum qualifications for the ideal future caregiver include: + 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 Preferred qualifications for the ideal future caregiver include: + Bachelor's of Science in Nursing (BSN) + Specialty certification Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we're dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/ **Physical Requirements:** + Requires full range of motion, manual and finger dexterity and eye-hand coordination. + Requires corrected hearing and vision to normal range. + May requires some exposure to communicable diseases or bodily fluids. + Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Even though the weight lifted may be only a negligible amount, a job should be rated Light Work: (1) when it requires walking or standing to a significant degree; or (2) when it requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or (3) when the job requires working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of those materials is negligible. **Personal Protective Equipment:** + Follows Standard Precautions using personal protective equipment as required for procedures. **Pay Range** Salaries [which may be] shown on independent job search websites reflect various market averages and do not represent information obtained directly from The Cleveland Clinic. Because we value each individual candidate, we invite and encourage each candidate to discuss salary/hourly specifics during the application and hiring process. Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities