Role Overview: This position provides PRN support for patients across multiple locations, focusing on advocating for individual health needs, promoting responsible health practices, and ensuring patient safety.
Key Responsibilities:
- Develops and implements care plans addressing bio-psychosocial factors and barriers to care.
- Provides care management for patients with complex conditions using assessment and planning skills.
- Facilitates safe, timely transitions between care levels, including home, emergency, inpatient, and post-acute settings.
- Utilizes telehealth, virtual visits, and home-based care, working effectively in various environments.
- Collaborates with interdisciplinary teams to ensure seamless patient handoffs and effective communication.
- Engages patients and families to align care with their values, goals, and functional independence.
- Addresses care gaps, leverages community resources, and adheres to legal and ethical standards.
- Works independently within license scope, documenting activities per policies and standards.
Qualifications & Skills:
- Registered nursing degree with a current, unrestricted license.
- Preferred certification: CCM or RN-BC, with attainment within 36 months if not already certified.
- Excellent interpersonal, verbal, and written communication skills.
- Proficiency in Microsoft Office and understanding of managed care and quality improvement principles.
- Experience with cardiovascular and respiratory assessments, critical thinking, and problem-solving.
- Ability to adapt to fast-paced, changing environments and manage multiple tasks effectively.
Working Conditions: Primarily telephonic and virtual visits, with some in clinical or hospital settings, requiring flexibility and adaptability. Equipment used includes computers, webcams, and standard office tools.