Public Health Nurse III (CalAIM)

Stanislaus County•Modesto, CA

6d•Hybrid

About The Position

The Public Health Nurse (PHN) plays a critical clinical and programmatic role within the CalAIM Justice-Involved Reentry initiative. Working under the supervision of the Program Manager, the PHN provides clinical oversight, guidance, and support to the Community Health Workers who deliver person-centered care coordination services to justice-involved Medi-Cal beneficiaries during the 90-day pre-release period. The PHN collaborates closely with the medical vendor, correctional health staff, Managed Care Plans (MCPs), ECM community providers, and internal leadership to ensure that reentry planning activities adhere to DHCS CalAIM Justice-Involved requirements, and facility protocols. The PHN reviews clinical assessments completed by the medical vendor, validates the accuracy and completeness of information used for reentry planning, and signs off on Reentry Care Plans developed by SCHW’s. The PHN supports program implementation, ensures compliance with regulations, and contributes to quality improvement and operational workflows. This is a lead Public Health Nurse position responsible for planning, coordination, implementation, assistance with the administration and direction of staff in assigned Public Health programs. These programs provide population based services in clinical and/or community settings focused on illness and injury prevention and health promotion through education, case management, and direct care and community collaboration. Areas of practice may include but are not limited to maternal and child health, communicable disease, chronic illness and HIV/STD. This position is subject to overtime, standby and callback assignments, and performs related duties as assigned.

Requirements

Bachelors of Science in Nursing
Four (4) years' experience as a Nurse, of which two (2) years is in Public Health as a Nurse. (An advanced degree in nursing, or a public health related field may be substituted for one year of the required experience.) OR Three (3) years' of increasingly responsible nursing experience in a public or private health care setting, with one (1) year as a case manager or public health nurse. (An advanced degree in nursing, or public health related field, may be substituted for one year of the required experience in case management or public health nursing)
Current valid California license to practice as a Registered Nurse
Current valid California Public Health Nurse certificate
Current valid BLS/CPR provider certificate
Willingness to complete a certified child abuse detection course as required by the State of California.
Proof of education, licenses and certificates are required for verification purposes at the time of application.
Strong clinical judgment
Excellent analytical and organizational skills
Experience in correctional or community health settings
Ability to interpret assessment data
Ability to provide clear clinical guidance
Ability to ensure that all care plans comply with DHCS, CalAIM, and facility standards
Strong communication skills
Ability to mentor, guide, and clinically support non licensed care coordination staff
Ability to collaborate effectively with the medical vendor, correctional health staff, PRCMs, Managed Care Plans, and community based providers
Ability to prioritize tasks
Ability to manage competing deadlines
Ability to function efficiently in a fast paced, multidisciplinary environment
Ability to maintain a high level of professionalism
Ability to maintain cultural competency
Ability to work effectively with individuals from diverse backgrounds
Knowledge of Principles and practices of public health nursing
Knowledge of The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy, Security and Breach Notification Rules
Knowledge of Basic principles of epidemiology
Knowledge of Pharmaceuticals, side effects, and possible complications of use
Knowledge of Health counseling methods
Knowledge of Standard nursing procedures
Knowledge of Interviewing techniques, and the methods used to gather data
Knowledge of Community resources likely to be needed by the client population served
Knowledge of First aid procedures
Knowledge of Prevention, detection, reporting and treatment of child abuse and neglect
Knowledge of Federal and State laws and regulations governing public health programs
Knowledge of Physiological, cultural, environmental, sociological and psychological differences and problems encountered in public health nursing
Knowledge of Disease investigation, control and prevention as related to chronic and communicable diseases and illnesses and injuries
Knowledge of Principles of program management and budgeting
Knowledge of Principles of employee supervision, staff development and personnel policies
Assess individuals and families including, physical assessment, health status and history, social support system and environment
Identify Public Health related nursing diagnoses and identify appropriate outcomes
Develop service plans with individuals, families and members of interdisciplinary teams
Initiate and follow through with activities
Administer medications, oral and injectable
Maintain client and program related documentation
Learn to utilize various types of information systems used by the agency or program
Communicate information to individuals and groups
Understand and interpret laws and regulation applicable to performance of responsibilities
Establish and maintain cooperative working relationships
Provide professional leadership and direction of personnel in a specific program and/or clinic, necessary to maintain the efficient delivery of effective Public Health care services
Direct the care/service given to a group of patients that includes coordinating the activities of the nursing clinic and/or program staff
Train, direct, check, review, assign and organize the work of other personnel, which may include Public Health Nurses I and II, Staff Nurses, Community Health Workers, Administrative Clerks, Health Educators, Public Health students, and/or volunteers
Employ critical thinking skills including analysis of data, problem solving and logical decision-making to address public health related issues
Analyze data, problem solve and make logical decisions
Write and prepare statistical and narrative reports
Pass County-paid pre-employment job-related background investigation.
Perform job duties in a manner assuring a safe working environment for oneself and others.
Maintain confidential information according to the legal standards and/or County regulations as required.

Nice To Haves

Experience working with justice involved or high needs populations
Correctional healthcare experience highly desirable
Knowledge of CalAIM
Knowledge of Medi Cal requirements
Knowledge of DHCS documentation standards
Knowledge of the Justice Involved reentry framework

Responsibilities

Review completed re-entry care plans, including physical, behavioral health, medication, chronic condition, and diagnostic summaries as well as goals, barriers, and Behavioral Health links.
Ensure clinical information used by SCHWs to develop Reentry Care Plans is accurate, complete, and aligned with CalAIM JI Initiative standards.
Provide clinical guidance to PRCMs regarding health needs, risk factors, continuity-of-care considerations, and service planning.
Sign off on individualized Reentry Care Plans to confirm clinical appropriateness, regulatory compliance, and adherence to DHCS CalAIM Justice Involved requirements.
Monitor the completion of clinical assessments, treatment updates, and service components performed by the medical vendor.
Consult with the medical vendor on complex health needs, medication access, DME requirements, and release related clinical considerations.
Work under the direction of the Program Manager to implement JI workflows, clinical oversight processes, and operational standards.
Ensure that reentry planning activities adhere to DHCS, CalAIM, and facility policies.
Provide clinical guidance during case reviews, staff meetings, and interdisciplinary care coordination discussions.
Assist in monitoring program performance, including timely completion of reentry care plans, accuracy of clinical content, and adherence to DHCS requirements.
Participate in audits, utilization reviews, and regulatory monitoring activities.
Identify gaps in clinical information or workflow processes and recommend improvements.
Support the Program Manager in meeting reporting requirements related to clinical oversight, service delivery, and care plan quality.
Maintain accurate clinical oversight documentation in the EHR and associated systems.
Verify that SCHW documentation meets clinical, programmatic, and regulatory standards.
Support FFS documentation and tracking requirements by ensuring clinical components related to billable services are accurately reflected in the EHR.
Ensure all activities comply with HIPAA, facility security protocols, and applicable state nursing and public health regulations.
Act as a resource for nursing problems and program-related issues, assigned to the Public Health program.
Plan, develop and oversee one or more Public Health programs including but not limited to assuring contract compliance, completion of reports and participation in grant applications.
Plan and oversee provision of direct client education on health maintenance, disease and injury prevention.
Plan and coordinate medical or comprehensive case management services to clients.
Plan, coordinate and participate in community assessment and collaborative activities to improve services.
Provide leadership for program planning and policy development.
Coordinate the planning and implementation of individual and community based outreach activities.
Participate in the preparation of budget development, oversight and reporting.
Report on the work performance of those overseen.
Prepare or assist in the preparation of annual staff evaluations under the direction of the Program Manager or other Public Health Management.
Participate in the hiring process.
Provide leadership and participate in emergency/disaster preparedness and response.