Patient Centered Health Home (PCHH) Nurse Case Manager

Affinia Healthcare Inc

  • St. Louis, MO
  • 2 days ago

    Highlights

    Marginal Functions: Assist providers with enrolled patients, take and record vital signs, abnormal results, distribute sample medications and administer injections per provider''s orders. Initiate the referral of high-risk patients and families for special services, team management, and track the patient''s referral (i.e.) abnormal lab results.

    Numbers & Facts

    LocationSt. Louis, MO

    Description

    POSITION SUMMARY: Perform the duties required to coordinate and monitor provision of wellness and prevention initiatives for patients enrolled in Primary Health Homes.

    POSITION QUALIFICATION REQUIREMENTS

    Education: Registered Nurse Diploma or Bachelor of Science in Nursing.

    Experience: Three (3) years as an RN in community clinic, public health nursing, and/or hospital setting; including dispensing sample drugs and monitoring effects.

    Skills and Abilities (which may be representative but not all inclusive of those commonly, associated with this position):

    • Good computer skills including the use of word processing and e-mail software.
    • Good oral and verbal communication skills.
    • Good organizational and self-motivation skills.
    • Ability to maintain confidentiality.
    • Ability to motivate and educate clients and staff.

    Transportation Requirement: Must possess a valid driver''s license and automobile with insurance coverage as required by the State of Missouri.

    License(s)/Certificate(s): Licensed as RN in the State of Missouri; CPR certification.

    FUNCTIONS OF THE JOB

    Essential Functions

    • Enrollment and management of required caseload. Completing monthly touches per regulations/guidance.
    • Assist in developing treatment plan health care goals for individuals with co-occurring chronic diseases.
    • Develop wellness and prevention initiatives.
    • Facilitate health education groups.
    • Keep patients'' records. Complete appropriate forms and reports. Provide appropriate documentation. Adhere to patient confidentiality.
    • Participate in the initial treatment plan development for all Primary care health home enrollees.
    • Assist in contacting medical providers and hospitals for admission/discharge.
    • Provide training on medical diseases, treatments, and medications.
    • Initiate the referral of high-risk patients and families for special services, team management, and track the patient''s referral (i.e.) abnormal lab results.
    • Collaborate with behavioral health and medical teams to develop patient-centered plan of care.
    • Track required assessments and screenings.
    • Assist with referrals to community and social support services.
    • Assist in implementing MHD health technology programs and initiatives (i.e., Cyber Access, metabolic screening).
    • Monitor HIT tools and reports for treatment.
    • Medical alerts and hospital admissions/discharges.
    • Monitor and report performance measures and outcomes.
    • Consult with Community Support Staff regarding identified health conditions.
    • Perform other duties as assigned.

    Marginal Functions:

    • Assist providers with enrolled patients, take and record vital signs, abnormal results, distribute sample medications and administer injections per provider''s orders.
    • Observe signs and symptoms, document, and report reactions of the treatment to the provider.
    • May perform home visits as needed.
    • Assist with implementation of Quality Improvement Programs.

    Supervises: None

    NOTE: SMOKING IS PROHIBITED IN THE WORK ENVIRONMENT

    NOTE: ALL APPLICANTS MUST PROVIDE CONTACT INFORMATION FOR THREE REFERENCES

    AN EQUAL OPPORTUNITY SERVICES PROVIDED ON A NON-DISCRIMINATORY BASIS

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