Discharge Care Registered Nurse - Manning - Care Management

El Rio Health • Tucson, AZ

1d • Remote

About The Position

The Discharge Care Registered Nurse, in collaboration with an interdisciplinary team, provides high-quality nursing care and patient safety in post-hospital discharge care management to optimize health and minimize the use of tertiary care services. This role applies the nursing process according to the Nurse Practice Act of Arizona and the Standards of Professional Performance of the American Academy of Ambulatory Care Nursing. Essential functions include communicating with recently hospitalized patients and/or families via telephone, collaborating with medical providers and interdisciplinary team members, and utilizing computerized software programs including Electronic Health Records (EHR). The nurse will document patient encounters, monitor EHR/EMR tasks, and gather information from acute-care facility medical records while adhering to confidentiality guidelines. This role also involves ensuring a safe work environment, participating in safety programs, and contacting patients before discharge to schedule follow-up appointments. The nurse will assess patient and/or family health learning levels to provide appropriate medical information and health education, discuss and reconcile medications, and review discharge planning to ensure patients receive prescribed durable medical equipment (DME), referrals, therapies, and specialist visits. After initial contact and resolution of post-discharge issues, care is transferred to Registered Nurse Care Coordinators (RNCCs). The position requires maintaining exceptional customer service, demonstrating El Rio Health’s Behavioral Standards and service excellence through AIDET principles, and promoting a professional, diverse, and respectful working environment. Patient confidentiality and HIPAA compliance are paramount, as is maintaining a clean, safe, and hygienic work environment. Understanding and proficiency with Joint Commission Certification (JCC) standards are also required.

Requirements

• A Degree or Diploma as a Registered Nurse from an accredited school of nursing, college, or university.
• One (1) years’ experience with hands-on patient care nursing, either in a hospital or clinic setting.
• Current Registered Nurse license in good standing from the Arizona Board of Nursing.
• Current certification in Basic Life Support (BLS) for health care providers.
• Level I fingerprint clearance card: current valid and in good standing or have applied for it within seven working days after beginning employment.
• Employees in this position are required to have reliable transportation that can meet any operational reassignments of the organization during the workday.
• If an employee is driving during work hours, the employee is required to possess a valid driver’s license and must comply with Arizona vehicle insurance requirements.

Nice To Haves

• Three (3) years’ experience with hands-on patient care nursing, either in a hospital or clinic setting.
• Previous Case Management experience.
• Previous nursing experience in: Emergency Department, Critical Care, Intensive Care Unit, or Medical Surgical environments.
• Certification in any, or all, of the following areas, Neonatal Resuscitation Program (NRP), Advanced Cardiovascular Life Support (ACLS), o Pediatric Advanced Life Support (PALS).
• Bilingual (English/Spanish) with the ability to speak, read and write in both languages.

Responsibilities

• Communicates with patients and/or families recently hospitalized via telephone in a timely manner based upon provider recommendations and risk stratification.
• Seeks collaboration with the medical provider as well as other interdisciplinary team members appropriately to optimize patient health.
• Uses computerized software programs including Electronic Health Records (EHR) and other organizational software programs.
• Documents patient encounters and health team interactions in appropriate software programs.
• Monitors EHR/EMR tasks and messages to assure timely management and response to patient/family and provider concerns and requests.
• Gathers information regarding hospitalized patients from acute-care facility medical record systems while adhering to confidentiality guidelines and protocols.
• Provides a work environment safe and free from hazards; immediately address safety issues or potential hazards; ensure workstations are ergonomically correct; provide staff with the Health and Safety Policies and Procedures and ensure compliance.
• Participates in all safety programs, which may include assignment to an emergency response team.
• Contacts patients and/or families before hospital discharge to schedule the initial El Rio Health PCP appointment.
• Assesses patient and/or family health learning levels in order to provide medical information and health education in culturally, linguistically and at the individuals appropriate literacy level.
• Discusses medications (prescribed and over the counter) with patient and/or family in order to reconcile medications prior/post hospitalization and to assure medication regimen compliance.
• Reviews discharge planning to assure the patient receives prescribed DME, referrals, therapies, and specialist visits/consults.
• After initial patient/family contact and resolution of post-discharge issues, transfers follow-up care to the Registered Nurse Care Coordinators (RNCC’s) based at the patient’s PCP El Rio’s health center location.
• Maintains exceptional level of customer service; addresses and resolves complaints; serves as an example by providing excellent service to internal and external customers, employees, and patients.
• Demonstrates and models El Rio Health’s Behavioral Standards in all interactions with patients, co-workers, and visitors.
• Demonstrates service excellence through the use of AIDET principles consistently applied with all patients, community members, co-workers, and colleagues.
• Coordinates and assists staff in providing excellent patient service.
• Works collaboratively with patients, families, providers, and co-workers.
• Embraces and promotes a professional working environment based on understanding and respect for diversity and multi-culturalism in all of its forms; demonstrates sensitivity, acknowledges varied beliefs, attitudes, behaviors, and customs, and encourages communication and appreciation of all forms of diversity.
• Maintains patient confidentiality by controlling the environment and information being disclosed to authorized individuals ensuring HIPAA and corporate compliance requirements at all times.
• Maintains a clean, safe, and hygienic work environment in compliance with all Policies and Procedures including but not limited to work areas, workstations, examination rooms, hand washing, infection prevention and control etc. for this position.
• Demonstrates an understanding of and proficiency with the application of all compliance and reporting requirements respective to Joint Commission Certification (JCC) standards.

Benefits

• Reasonable accommodations may be made to enable individuals with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for sincerely held religious beliefs, observances, and practices to perform the essential functions of the job.
• El Rio Health does not discriminate based on race, color, religion, sex (including pregnancy, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, or other non-merit-based factors. It is our intention that all qualified applicants be given equal opportunity and that selection decisions are based on job-related factors.
• El Rio Health requires all AZ employees to have a Level One Fingerprint Clearance card. A.R.S. 36.425.03. New hires and transfers must submit their fingerprint clearance card or fingerprint receipt before their hire date or transfer date. Level One (1) Non-IVP Fingerprint Clearance card must be received within 30 days after the new employee hire date or transfer date.
• All employees are strongly recommended to obtain and maintain vaccination status (i.e., as recommended by CDC and/or other public health agencies) to include an Influenza vaccination. Subject to exemptions and accommodations when required by law. (Policy: Adm-016 & Adm-045).
• All employees are required to undergo drug testing prior to employment and will be subject to post-accident, reasonable suspicion, return to duty and follow up drug and alcohol testing in compliance with Federal and State regulations for alcohol and controlled substance testing.
• Employees in positions holding responsibility for the safety and welfare of others will also be classified as safety sensitive.
• El Rio Health is a non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and abides by all applicable federal Drug-Free Workplace standards.
• El Rio Health is an equal opportunity employer.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree