- Collaborate with providers and partner agencies to provide interdisciplinary care management to facilitate patient-centered care plans and goals, and to meet patient needs.
- Implement the care management process utilizing nursing assessment skills to improve patient health outcomes (assessing, educating, facilitating, goal setting, advocating, and evaluating progress toward patient goals) prioritizing face-to-face patient interactions versus telephone care management.
- Assess patients for appropriate level of care management services per program standards and ensure adherence to all program specific guidance documents, approved polices, and contracts.
- Establish, maintain, and seek to improve relationships with medical homes, providers, and practice staff to ensure patient is well-connected to their medical homes.
- Manage patients with a focus on crisis prevention, stabilization, and problem solving; address the total individual, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs as they relate to patient goals.
- Utilize motivational interviewing skills to assist patients in progressing toward their goals.
- Promote patient centered care management and education by involving patients and their support systems (i.e. caregiver, family, etc.) in the decision-making process.
- Effectively provide education to patients/caregivers about clinical diagnosis, medication, and available resources to achieve optimal self-management.
- Evaluate and prioritize referrals and refer patients to internal and external resources as appropriate.
- Maintain a caseload of enrollees, based on programmatic expectations for optimal impact of priority populations.
- Review care management benchmarks and chart audits to identify areas of improvement and demonstrate progress toward established goals.
- Provide in-home high-risk maternity visits, post-partum assessments, and newborn assessments as ordered by medical provider.
- Provide direct public health nursing services, client assessment, education, and non-judgmental counseling; administer medications and treatments per medical orders or standing orders.
- Provide immunizations for vaccine preventable diseases via State and CDC guidelines and education of parents/clients regarding immunization laws, schedules, and care following immunizations.
- Participate in activities related to preparedness for and response to bioterrorism and other public health threats as needed.
- Perform other related duties as assigned.
- Knowledge of programmatic goals and related performance measures.
- Knowledge of the organization of Public Health programs at local and state level including knowledge of principles and practice of public health nursing services.
- Knowledge of NC state nursing practice act and laws.
- Knowledge of and compliance with federal and state regulations applicable to the position.
- Knowledge of available community resources to provide patients with appropriate resource and service linkage.
- Knowledge of medical, behavioral, and socio-economic problems and their treatment.
- Ability to prioritize, identify and assess risks, problems, and needs.
- Skill in establishing constructive relationships with patients and community agencies.
- Knowledge of health trends and practices that are pertinent to the population of patients served.
- Knowledge of community resources and ability to link clients to a larger system of community-based, prevention/intervention services.
- General knowledge of current social and economic problems relating to public health, including health disparities.
- Ability to deal tactfully with others and to exercise good judgment in appraising situations and making decisions.
- Ability to work in partnership with patients and with other service providers to elicit needed information and to maintain effective working relationships.
- Ability to record accurately services rendered and to interpret and explain records, reports, and medical instructions.
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rn care coordinator - Woodfin, NC , USA, United States - Buncombe County (NC)
Description
Job Title:
RN Care Coordinator
Department:
Health and Human Services
Hiring Range:
$56, $69,752.71
Compensation Grade: 3004
Compensation Pay Range:
$56, $87,959.31
Posted Internally and Externally
Job Posting End Date:
May 06, 2024
Buncombe County offers in-office, hybrid, and remote positions.
Employees in positions that are approved for remote work must work at a location within a 2-hour drive from the position's assigned Buncombe County facility.
Purpose of the position:
The purpose of this position is to ensure that eligible patients (pregnant women and children 0-5 years of age), with primary focus on populations who will benefit from intensive care management services, receive comprehensive and cost-effective health care services.
Additionally, this position will provide professional nursing services related to public health and community health care services in health promotion, prevention, and disease control.
Minimum Education, Training and/or Experience (required at time of hire): Bachelor's degree in Nursing (BSN) from an appropriately accredited institution which includes a Public Health Nursing rotation and one (1) year of Public Health Nursing experience; or Master's degree in Public Health, graduation from a school of professional nursing and two (2) years of professional nursing experience including one (1) year of Public Health Nursing experience; or an equivalent combination of education and experience.
Additional Training and Experience:
Two (2) or more years of experience preferred in any of the following: Clinical Utilization Management, Discharge Planning, Home Care, Pediatrics, Long Term Care, Acute Care Facility and/or Ambulatory Care/Physicians' Office, or at least one year of Care Management experience preferred.
Work involving direct patient contact and customer service favorably considered. Passing score on the Certified Case Manager Exam and successful completion of CCNC Care Management Competencies, preferred.
License or Certification Required by Statute or Regulation: Current, unrestricted RN License to practice in North Carolina; Valid NC driver's license.
Essential Functions of the position:
Knowledge, Skills, Abilities:
All new employees are paid according to their years of relevant education and experience above minimum requirements for the position and employees have the opportunity to obtain pay increases via cost of living increases and promotions.
Buncombe County Government realizes the importance of a diverse professional workforce and the need to foster a responsive and innovative organizational culture, one that fully engages all of our employees, honoring and building on each employee's unique experiences, opinions, and perspective.
It is the policy of Buncombe County to provide equal employment opportunities (EEO) to all persons regardless of race, color, religion, sex, national origin, political affiliation, physical or mental disability, age, veteran status, genetic information, sexual orientation, gender identity or any other legally protected class under federal or NC State law.
Applicants for employment are invited to participate in the affirmative action program by reporting their status as a protected veteran or other minority.
In extending this invitation, we advise you that:
(a) workers (applicants) are under no obligation to respond but may do so in the future if they choose; (b) responses will remain confidential within the human resource department; and (c) responses will be used only for the necessary information to include in our affirmative action program. We are a company that values diversity. We actively encourage women, minorities, veterans and disabled employees to apply. Refusal to provide this information will have no bearing on your application and will not subject you to any adverse treatment.
