Reliant Medical Group is seeking a Clinical RN Specialist in Infectious Disease to join our excited and innovative organization!
Full Time benefited: 35 hours
Hours: Monday - Friday 9:00AM - 5:00PM
No nights or weekends
Patient Nurse Manager, Disease Management
Managers certain aspects of specific disease management care for a panel of patients, patients who are enrolled in the HIV/Hep C Disease Management Program.
Works collaboratively with physicians, staff and other health care professionals to provide medical care coordination across the health care continuum for all patients within the physician office setting. Responsible for coordinating a wide range of self-management support and disease registry activities.
* Provides comprehensive care management and care coordination for a specific panel of patients enrolled in the HIV/HEP C Disease Management Program as needed.
* Identifies patients that are overdue for visits, labs or tests.
* Identifies patients that do not meet clinical goals and arranges for follow-up services following standard procedures.
* Provides education to patients regarding specific health care skills and general disease concepts.
* Drafts patient communication as needed for educational and programmatic updates.
* Communicates the care plan to the patient, caregiver, and specialist.
* Coaches patients to improve health behaviors to attain mutually agreed upon health goals.
* Addresses medication adherence in patients not meeting outcome goals.
* Manages and follows-up according to established care plan, through telephone calls, or on office visits with the specialist.
* Promotes the communication process between all care team members, including the patient, family and all parties involved to enhance collaboration and achieve optimal outcomes for the patient.
* Incorporates self-care and share decision making aspects of patient care.
* Links families and patients to appropriate clinical disciplines within the care team to facilitate education for better self-management and navigation within the health care system.
* Follows-up with patients using My-Chart or reaching out via telephone.
* May help to manage and coordinate transitions of care if necessary.
* Ensures that relevant providers receive timely clinical documentation, or date for care treatment decisions in specialty care.
* Provides support to direct caregivers, including ad hoc telephone advice.
* Communicates and coordinates with the health-care team in the development of tools for optimal patient outcomes and report findings.
* Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
* Complies with established departmental policies, procedures and objectives.
* Enhances professional growth and development through educational programs, seminars, etc.
* Attends a variety of meetings, conferences, and seminars as required or directed.
* Performs other specific duties that may be required.
* Regular, reliable and predictable attendance is required.
* Graduate from an accredited school of Nursing
* Active, unrestricted license as a Registered Nurse in Massachusetts
* current Massachusetts Driver's license
* Bachelor of Nursing preferred
* Three to Five years clinical experience with extensive experience in Infectious Disease, HIV & Hepatitis C disease management
* ACRN certification preferred or willingness to obtain certification within 2 years
* Excellent organizational, interpersonal, communication and assessment skills required
* Proficient in computer use, Microsoft Office, the Internet and health information technology
* Works effectively both independently and as a member of a health care team
* Flexible and creative with the ability to work well with diverse populations
* Adept at multi-tasking