At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence. Job Description **Summary of Primary Function/General Purpose of Position** Guides patients through the healthcare system and removes barriers by assisting with access issues, developing relationships with service providers and tracking interventions and outcomes in specialty area. **Essential Job Functions** + Coordinates the episode of care for all patients including: coordination with the physician offices to ensure proper screening of patients for high risk medical and functional issues, coordinating specialist appointments for optimization of patients prior to surgery, completion of patient reported outcome forms, ensuring completion of pre-operative H&P, coordination of follow up appointments, and help in coordination of post-operative discharge plan; assesses and identifies high risk patients (medically, functionally, socially) in order to ensure that adequate resources are arranged and clinical pathways are followed in order to optimize patient outcomes prior to surgical intervention; participates in development and implementation of pre-operative educational class, whatever the format may be (in person, web-based, paper), and ensures that educational material is distributed prior to the surgical phase of care; assists in educating patients on any remote access monitoring system utilized for the program + Participates in review of quality metrics in an effort to maximize our outcomes, specifically in relation to discharge disposition and readmission rates; assists in appropriately determining needs for patients at discharge and helps to coordinate service if needed-specifically home health care, outpatient PT, remote monitoring systems, etc. + Acts as a liaison between the physicians, health care staff, and the patient to ensure a successful episode of care; follows up on patients and initiates a yearly follow up as necessary per specialty for final completion of patient reported outcome measures + Participates in staff education on an individual or group basis as needed; updates nurse manager on changes that could impact care delivery; maintains regulatory knowledge of specialty area at the federal, state, and local level. **Employment Qualifications** **Required Minimum Education:** 4 Year/ Bachelor's Degree **Specialty/Major:** Nursing **Preferred Education:** Masters **Specialty/Major:** Nursing **Licensure/Certification** **Required:** Current nursing license in the State of Ohio BLS- through American Heart Association required **Licensure/Certification** **Preferred:** Hold national certification in clinical specialty or leadership within 6 months of eligibility **Minimum Years and Type of Experience:** Minimum of two years of previous experience in clinical specialty **Other Knowledge, Skills and Abilities Required:** Ability to effectively communicate with diverse audiences; strong organization and detail orientation skills; prior experience working in protocol/pathway driven environments; strong critical thinking skills **Other Knowledge, Skills and Abilities Preferred:** **Previous experience in Oncology preferred** ; care coordination or discharge planning helpful Many of our opportunities reward* your hard work with: Comprehensive, affordable medical, dental and vision plans Prescription drug coverage Flexible spending accounts Life insurance w/AD&D Employer contributions to retirement savings plan when eligible Paid time off Educational Assistance And much more *Benefits offerings vary according to employment status All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com