Chronic Care Nurse

University of North Dakota•Bismarck, ND

About The Position

A Chronic Care Nurse plays a vital role in the healthcare system by providing specialized care and support to individuals managing long-term health conditions. These dedicated nurses work closely with patients to develop personalized care plans aimed at improving their quality of life, managing symptoms, and preventing complications. Their responsibilities encompass a wide range of activities, including patient education on medication management, lifestyle modifications, and self-care techniques. Chronic Care Nurses often act as intermediaries between patients and other healthcare providers, ensuring seamless communication and coordinated care. They conduct regular assessments to monitor the progression of the disease and adjust treatment plans as needed. By offering continuous support and resources, these nurses empower patients to take an active role in their own health. Their expertise not only alleviates the burden of chronic illnesses but also helps reduce hospital readmissions and enhance overall patient outcomes. Integrating compassion with clinical skills, Chronic Care Nurses are essential advocates for patients navigating the complexities of chronic disease management.

Requirements

Excellent interpersonal skills and ability to work closely with faculty and resident physicians.
Ability to work with patients and the public in a professional, confidential, and calm fashion.
Strong oral and written communications skills.
Strong computer skills with experience in electronic health records.
Ability to adhere to clinic safety protocols.
Ability to adhere to clinic policies and procedures.
Associate's degree in nursing or equivalent.
Successful completion of a Criminal History Background Check.
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the US and to complete the required employment eligibility verification form upon hire.
This position does not support visa sponsorship for continued employment.

Nice To Haves

Three years of nursing experience in a clinical setting.
Experience with care coordination and chronic care management.
Epic electronic health record experience.

Responsibilities

In collaboration with the provider, develop and implement individualized care plans for patients with chronic conditions.
Monitor and evaluate patient progress and adjust care plans as necessary.
Educate patients and their families about disease management and prevention strategies.
Coordinate with other healthcare professionals to ensure comprehensive care.
Administer medications and treatments as prescribed by physicians.
Perform routine assessments and document patient outcomes.
Assist in the development and implementation of chronic disease management programs.
Complete follow up phone calls to chronic care patients.
Complete phone calls for hospital follow up and transitional care management patients.
Document and communicate nursing interventions and patient responses to appropriate members of the health care team.
Documentation is completed in patient’s electronic chart as per established protocol(s).
Electronically refill prescriptions to pharmacy as ordered by physician with accuracy.
Reports and tracks laboratory test results, and other diagnostic testing as indicated by Risk Management Policies and Procedures.
Ensure compliance with healthcare regulations and best practices.
Participates in quality improvement activities.
Attend meetings, seminars, and conferences as appropriate.
Complete accurate and timely third-party payer prior authorization requests, through payer portals or by phone and follow up consistently on pending cases.