Clinic RN - Care Coordination Program Supervisor

Job Details: Job Location: Willapa Medical Clinic - South Bend, WA, Salary Range: $47.00 - $55.00Hourly, Job Shift: Day, Pay

$47.00 - $55.00 / hour BOE - Medical, Vision & Dental Benefits, 403b plan. EOE 

Shift

Full Time Monday–Friday 40hrs/week

Description

Provides exceptional patient care in a collaborative and supportive clinical environment. Responsible for ensuring patients receive comprehensive, high-quality care, working closely with providers and the interdisciplinary team to meet patient needs. Responsible for not only clinical tasks but also helping to ensure continuity of care through coordination, patient education, and direct care for a variety of patient needs.  

Responsibilities

Works cooperatively within own department and with other employees in other departments.
Willingly assumes additional responsibility to support the team efforts of own and other departments.
Consistently uses good written and verbal communication.
Show the appropriate care, courtesy and respect to all guests, patients, physicians and other employees that they deserve.
Upholds the highest confidentiality that the hospital requires.
Maintains a positive attitude under the most trying of circumstances.
Always have a good and flexible attitude to changes that take place in the department.
Follows all direction concerning changes and acts accordingly.
Maintains a well organized and clean environment to work at maximum efficiency and promoting good quality standards.
Ability to use own initiative to figure out problems.
Care Coordination / Care Management

Work closely with healthcare providers and interdisciplinary teams to ensure coordinated, comprehensive patient care. manage care for patients with complex conditions, ensuring that each patient's individual care plan is followed and any gaps in care are addressed. This included monitoring care needs, coordinated follow-ups, and ensuring timely interventions as necessary. Assists with staff development and problem solving.
Follow and manage a panel of complex patients, ensuring that their care is properly coordinated across multiple settings, including referrals to specialists, follow-up care, and addressing any emerging patient needs/concerns as they arise. Monitor for changes in patient conditions and initiate necessary interventions. Apply appropriate charges for care provided when applicable
Reach out to patients recently discharged from the emergency room or hospital to schedule follow-up appointments ensuring continuity of care, addresses patient concerns, and supports a smooth transition from acute to outpatient care. Inform patient's care provider of any pertinent patient information or care coordination needs post discharge.

Telephone Triage

Assess and respond to patient inquiries via telephone, providing appropriate guidance, advice, disposition, and follow-up instructions based on protocol. Ensure Timely and accurate advice is provided and coordinate with the healthcare team to facilitate next steps, including referrals or in-person visits.

Nurse Visits

Provide direct patient care during scheduled nurse visits (ex: screenings, immunizations, dressing changes, education,m adherence support, diabetes, hypertension, etc.), performing through assessments, administering treatments, and addressing patient needs. You will assess each patient's status and use critical thinking to provide ongoing interventions.

Patient Education

Educate patients and families on medical conditions, treatment plans, medications, and lifestyle modifications to promote health and wellness. Focus on proactive management of chronic conditions, as well as preventive care. Provide education on advanced care planning, encouraging patients to make informed decisions about their healthcare.

Wound Care

Perform thorough wound assessments, treatment, and ongoing care for patients with various types and stages of wounds. Administer wound care procedures such as dressing changes, debridement, and monitoring for infection. Document progress and adjust care plans as needed.

Advanced Care Planning

Provide guidance and education to patients and families on advanced care planning, including discussing treatment preferences, living wills, and healthcare proxies. Ensure that patients understand their care options and assist in the documentation of their wishes.

Clinical Duties

Perform other clinical tasks required, including administering medications under physician/provider orders (such as immunizations, antibiotics, injectable medications), performing laboratory tests, and assisting with procedures. Assess patients' needs, coordinate with providers, and follow through on necessary orders. Inform & execute standing orders.

Maintaining Scope of Practice

Work to the highest level of your scope of practice, ensuring that all clinical duties are performed according to professional standards. Delegate appropriate tasks to support staff as necessary, maintaining patient safety and ensuring the effective delivery of care.

HIPAA Compliance

Ensure compliance with HIPAA regulations at all times. Maintain confidentiality of all patient information and ensure that all patient interactions, records, an communications adhere to HIPAA guidelines to protect patient privacy.

Documentation & Communication

Ensure accurate and timely documentation of patient interactions, care provided, and follow-up actions taken. Communicate effectively with the healthcare team to ensure all patient needs are addressed promptly and thoroughly. This includes documenting patient information in the Electronic Health Record (EHR), including assessments, care plans, and treatment outcomes.
The RN will perform telephone triage, in-basket coverage for messages, test results, and refills, as well as hands-on responsibilities such as patient teaching, blood pressure checks, responding to medical emergencies, and rooming patients.
This is a team-driven clinic, where nurses work closely with providers and other nurses to ensure patient needs are met effectively.

Quality Improvement & Patient Safety

Participate in performance improvement initiatives to enhance clinic processes and ensure high-quality patient outcomes. Report and address adverse events and engage in continuous learning to maintain best practices in patient safety.

Qualifications: Required

Associate’s Degree in Nursing (ADN)
Current Washington State Registered Nurse (RN) License
Basic Life Support (BLS) certification
At least 1 year of experience in a clinical setting
Strong communication skills, with the ability to educate and interact effectively with patients and families.
Previous leadership or delegatory experience
Ability to manage a panel of complex patients, coordinating care across different providers and settings.
Ability to handle fast-paced environment with multiple priorities.
Compassionate, detail-oriented, and patient-focused approach to care.

Preferred

Bachelor’s Degree in Nursing (BSN)
Experience in Primary Care
Experience in wound care, care coordination, and care management.