Registered Nurse

St Johns Community Health•Los Angeles, CA

21d•Onsite

About The Position

Actively contribute to the development of the Registered Nurse role. RNs to act as a bridge between Patient’s Services and Provider care, establishing a strong working relationship with Clinic Manager and Lead Provider at site. RNs will work closely with Director of Clinic Operations, Lead provider and Medical Leadership. RNs will work closely with Clinic Manager to improve patient flow. RNs and Clinic Managers will work closely with Director of Programs to ensure proper integration of numerous patient programs. Job responsibilities include: serves as the center’s on-site clinical liaison; responsible for ensuring core clinical competencies of CMAs, CHWs and care managers-assures that all direct patient care staff are trained to be proficient in clinical competencies; monitors performance improvement plans, collaborates in developing team priorities, patient goals, chronic disease care management, performs symptom based triage and screening guided by guidelines and/or policies and procedures, participate in the dissemination of patient education, patient self-management teaching, coaching, and support, panel management, care coordination, proficient in the use of the electronic health record and practice management systems, and assures compliance with all agency policies and procedures.

Requirements

Associate in Nursing
RN licenses required
Supervisory, Teaching/Education, Process Evaluation and Creativity.
Employees are responsible for maintaining individual certifications as required by job function or by law and provide.
Verification and recertification when requested by management.

Nice To Haves

Bachelor Degree Preferred
Bilingual English/Spanish (Preferred)
Community health experience preferred.

Responsibilities

Serves as the center’s on-site clinical liaison
Responsible for ensuring core clinical competencies of CMAs, CHWs and care managers-assures that all direct patient care staff are trained to be proficient in clinical competencies
Monitors performance improvement plans
Collaborates in developing team priorities, patient goals, chronic disease care management
Performs symptom based triage and screening guided by guidelines and/or policies and procedures
Participate in the dissemination of patient education, patient self-management teaching, coaching, and support
Panel management
Care coordination
Proficient in the use of the electronic health record and practice management systems
Assures compliance with all agency policies and procedures
Supports and implements the organization’s vision, mission and values.
Works independently with minimal supervision to determines priorities and method of completing daily workload to insure that all responsibilities are carried out in a timely manner.
Performs all job functions in a professional and courteous manner. This includes answering all general phone calls timely. Provide excellent customer service to internal and external customers by being responsive to all inquiries in a timely manner.
Guides, directs, coaches and motivates staff regarding work performance, problem solving, and decision making to ensure staff meet work standards. Ensures clinical competencies.
Performs job duties collaboratively with health center management team and exercises good judgment.
Fosters and promotes a culture of service excellence and accountability.
Assists with development of policies and procedures for case management, clinical competencies and clinical workflows.
Responsible for carrying out key functions related to the success of the PCMH model including outreach activities, PCMH reporting, performance measurement, and acting as key liaison between practice.
Ensures the overall success of the PCMH model by collaboratively working with patients, physicians and practice teams to integrate key features of the PCMH model.
Reviews and assesses the patient’s available data, including clinical history, outpatient treatments, inpatient treatments, emergency room visits, medications, medical benefits from electronic Medical Records. (EMR), chart reviews, or other information, to assist in the monitoring and facilitation of adherence to prescribed treatment plans.
Performs symptom-based triage and screening guided by guidelines and/or policies and procedures.
Facilitates patient’s understanding of the physician’s treatment plan, including but not limited to, prescriptions, refills, medical supplies, referrals, authorization of services, and when to seek care.
Defines, assesses, and understands the health status of individuals and populations, determinants of health and illness, factors contributing to health promotion and disease prevention, and factors influencing the use of health services.
Tracks and records patient’s progress, plans, implements and adjust individualized care management according to the patients’ needs. Provides clinical follow up to insure patient self-care goals are being met. Helps with calling patients with Lab results. Coordinate Patient Lab Calls with Providers.
Utilizes appropriate methods for interacting and collaborating sensitively, effectively, and professionally with persons from diverse cultural, socioeconomic, educational, religious, racial, ethnic and professional backgrounds, and persons of all ages and lifestyle preferences.
Delivers professional nursing services as defined by the practice standards for a registered nurse and functions as a service provider, educator, coordinator, case manager, evaluator, advocate, and facilitator of health and health services for individuals and groups. May be tasked do cover clinical areas such as laboratory and dispensary.
Assures that all direct patient care staff are trained to be proficient in clinical competecies, the use of the electronic health record and practice management systems, and assures compliance with all agency policies and procedures.
Provides consultation to facilitate understanding and influence the specified plan of care, to enhance the abilities of others, and to effect change. Analyzes the assessment data to determine the health issues and nursing diagnosis.
Uses procedures, referrals, treatments, therapies, and prescriptive authority (if applicable) in accordance with state and federal laws and regulations.
Participates in provider education when called upon to do so. Participates in the development of education programs for patients with diagnoses within designated Chronic Disease Management categories.
Coordinates, analyzes situations, makes decisions and takes initiative to maximize integration efforts. Contributes and actively participates in gathering educational information pertaining to chronic diseases affecting the assigned patient population.
Participates in health center disaster preparedness program.
Part of healthcare team that works to sustain attainment of St. John’s Health Centers certifications including but not limited to the Patient Centered Medical Home and other certifications as required.
Promotes health centers’ services by participating in community groups, outreach activities and meetings. Communicating regularly with care coordinators, care teams and physicians.
Actively participates and assists in the Quality Improvement Programs for St. John’s Health Centers including, but not limited to measuring quality improvement initiatives and identify, test, refine and implement clinical policies and procedures. Monitors tracking mechanisms utilizing the electronic health record to evaluate chronic disease quality indicators.
Uses discretion and judgment in handling sensitive or confidential information, answers all employee and client inquiries in a timely and courteous manner and listen to employee disputes and understands which decisions can be made alone and which decisions need to involve others.
Consistently adheres to a high standard of professional ethics: Conducts self in an ethical manner and is a role model to others ensures that a professional code of ethics is followed by staff and others throughout the organization.
Complies with organizational policies and procedures.
Dispense medication to patients when needed
Perform chart audits to follow up on referrals by Diagnosis (i.e: PAPS, diabetes).
Performs all other duties as assigned.
Develop and oversee Medical Assistants functions, i.e. MA procedures, protocols, data-entry requirements.
Provide regular MA Training on procedures, processes, data-entry, accountability and documentation.
Work with Clinic Managers, to develop Patient Education Programs.
Mentor and encourage continuing education for MA’s including National Certification.
provide education and training classes on additional topics identified.