RN Care Management & Visiting Nurse Services

McKenzie Health • Watford City, ND

2d

About The Position

McKenzie Health is looking for a compassionate, organized Registered Nurse to support our population health initiatives through Chronic Care Management (CCM), Transitional Care Management (TCM, and Visiting Nurse Services (VNS). The RN will provide both telephonic and in-home skilled nursing services to improve patient outcomes, reduce hospital readmissions, and support value-based care initiatives. The position works closely with primary care providers and the Population Health team to coordinate high quality care.

Requirements

• Strong assessment and critical thinking skills
• Excellent communication and patient education abilities
• Ability to work independently while collaborating with Population Health Nurse and providers.
• Utilize EMR, Microsoft Windows, and Excel efficiently.
• Active, unencumbered RN License in ND.
• Current BLS

Responsibilities

• Chronic Care Management (CCM) Conduct monthly telephonic outreach to patients with multiple chronic conditions.
• Perform ongoing assessment of health status, medication adherence, and barriers to care.
• Provide patient education and preventative health counseling.
• Coordinate referrals, specialty appointments, and community resources.
• Develop, update, and document individualized care plans.
• Maintain exact, compliant documentation for billing purposes.
• Transitional Care Management (TCM) Contact patients within two business days of hospital discharge.
• Assess symptom changes, complications, and social barriers.
• Coordinate and schedule face to face follow up visits within 7-14 days.
• Work to reduce readmissions and emergency room use.
• Visiting Nurse Services (VNS) Provide skilled nursing care in the home setting.
• Perform patient assessments and check overall health status.
• Educate patients and caregivers on disease management and self-care.
• Collaborate with providers to develop and update care plans.
• Nothing in this job description restricts MH ability to assign, reassign or eliminate duties and responsibilities of this job at any time.
• MH does not restrict the tasks that may be assigned.
• Critical features of this job have been described; those features may be changed at any time due to reasonable accommodation or other reasons deemed appropriate by MH.

Benefits

• Comprehensive benefits, including 100% retirement, match up to 6% (403b).
• Employer- supported education and training opportunities.
• Childcare subsidy program.
• Complimentary membership to the Connie Wold Wellness Center.
• Service awards, recognition programs, and branded clothing provided.
• Employee Assistance Program (EAP)
• Supportive, collaborative environment with strong commitment to work-life balance.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed