Registered Nurse

Summary

The purpose of this position is to provide general nursing care and leadership, working collaboratively with physicians and multidisciplinary team members. The successful candidate will oversee the day-to- day functions of the Chronic Disease Management team. Their goal will be to improve the health, wellbeing, and satisfaction of patients and their families with chronic and complex diseases.; monitor patient compliance with current disease specific clinical guidelines; educate patients and their families on their specific disease processes, and provide ongoing assessment, monitoring, and re-evaluation of health related needs.

In addition, the R.N. will promote and restore patient’s health as they provide for, delegate, evaluate and coordinate comprehensive professional nursing care for patients of all ages, gender, cultures, and background. Provide physical and psycho-social support to patients, friends, and families. This individual may oversee clinical care of other personnel including LVN’s and MA’s.

Overall Essential Functions

1. Performs all job functions in a professional and courteous manner. This includes answering all general phone call timely. Provide excellent customer service to internal and external clients/patients by being responsive to all inquiries in a timely manner.

2. Performs job duties collaboratively with health center management and exercises good judgement.

3. Fosters and promotes a culture of service excellence and accountability.

4. Consistently adheres to a high standard of professional ethics; conducts self in an ethical manner and is a role model to others.

5. Complies with organizational policies and procedures.

6. Oversee the day-to-day functions of the Chronic Disease Management team.

7. Responsible for providing direct nursing patient care services within scope of practice.

8. Responsible for case management of the chronically ill patients, specifically diabetic patients.

9. Conduct audits pertaining to Chronic Disease Management Programs and clinical records review.

10. Triage by Phone

11. Recommends, documents, and executes standard protocols for closing gaps in preventive and chronic disease management services on behalf of practices

12. Lab result review, critical laboratory tracking

13. Radiology Tracking log

14. Medication Refill

15. Accesses practice medical record, health plan and physician organization registries for the sole purpose of identifying patient level gaps in care

16. Accesses practice schedule to identify upcoming appointments for patients with gaps in care

17. Prepares and mails outreach letters or portal messages to patients on behalf of practice

18. Conducts telephone outreach to patients to facilitate gap closure

19. Documents outreach and gap closure in medical record and/or registries

20. Prepares reports to track patient interventions by practice in order to demonstrate value of panel management and outreach activities

21. Identifies and refers appropriate patients to care management

22. Other duties as assigned

Patient Care Duties

1. Assess, plan, direct and evaluate total nursing care as determined by the patient’s age related physical, psychosocial, and cultural needs in accordance with established standards, policies and procedures of the Bartz Altadonna Community Health Center.

2. Provides case management by being a patient advocate, resource and contact person for patients.

3. Provides basic education information to patients and family, focusing on self-care appropriate to their age and identified learning considerations and needs.

4. Performs assessment data collection and documents subjective data (chief complaint and allergies) and objective data (vital signs/weight/etc.). Reviews basic health history information for patients; focusing on environmental, self-care and clinic discharge planning.

5. Administers medications and intravenous solutions skillfully and correctly and performs lab/diagnostic testing as ordered by provider and reports all critical lab values immediately.

6. Demonstrates an ability to remain calm, perform effectively and professionally during peak periods of activity and emergency situations.

7. Anticipates and prepares examination room with equipment and supplies required for the visit. Assists provider with examination and procedures per request.

8. Utilizes universal precautions in obtaining specimens (venipuncture, cultures, etc.) and in delivery of patient care. Performs lab testing (i.e. urine dip, pregnancy test, strep screen, hemicube) including quality controls and maintains all laboratory/diagnostic test logs.

Team Duties

1. Evaluates the effectiveness of the care given by interdisciplinary care team and identifies problems and guides team members to their solution.

2. Assigns care team members in accordance with patient needs, staff capabilities and qualifications to meet the needs of the clinic.

3. Participates in training, orientation, competency assessment and education of new employees.

Minimum Qualifications

· Current RN License recognized by the State of California Board of Nursing.

· Has a Bachelor of Science in Nursing (BSN)

- Knowledge of nursing care in accordance with regulations and practices established by the California Board of Nursing.

· Consistent demonstration of a team approach to care.

· Ability to effectively communicate both in writing and orally.

Preferred Qualifications

· Bilingual, preferably Spanish speaking.

· Experience in Community Health Centers.

· Computer literate.

· BCLS certified.

Physical Demands

This is mostly in an office setting; however, this position may require sitting for prolonged periods of time. Walking, bending, and reaching may be required as well.

Position Type and Expected Hours of Work

This is a full-time position. Days and hours of work are eight (8) hours Monday through Friday

Travel

On occasion travel will be required.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice to fit the needs of this position and BACHC.