RN Health Coach

CommonSpirit Health • Bismarck, ND

12d

About The Position

The RN Health Coach works in the clinics and uses the professional nursing process to provide individualized nursing care across the life span in an ambulatory setting. The role supports patients through preventative care, health maintenance, diagnosis, treatment, and follow-up, and coordinates care plans with specialty practices and inpatient facilities across the continuum.

The RN Health Coach works with patients and families through education, goal setting, action planning, problem-solving, and motivational interviewing to support health behavior change. The position manages disease registries, identifies and follows up with patients who are not meeting evidence-based clinical goals, and assists with pre-visit chart reviews to identify preventive care needs. Success in the role requires communication, independence, assertiveness, critical thinking, flexibility, organization, and the ability to work autonomously with little direction. The role also requires knowledge of reimbursement for services and a commitment to continuous quality improvement.

Requirements

• Currently licensed with the applicable state nursing board and/or possess multistate licensure privileges.
• Function within the legal scope of practice.
• Hold a valid driver's license.

Nice To Haves

• At least three years of professional nursing experience in a clinical care setting.
• Bachelor's degree in nursing.

Responsibilities

• Utilize the nursing process to manage patients with chronic disease within the Patient-Centered Medical Home.
• Conduct pre-visit chart reviews to identify gaps in preventive health maintenance, immunizations, and chronic disease interventions.
• Collaborate with physicians, APPs, staff, and other professionals to coordinate care across the continuum.
• Facilitate mutual goal setting and goal-directed interactions with clients and families to support health behavior change.
• Act as a patient advocate, responding to and working to resolve patient concerns as a liaison with specialty clinics.
• Participate in quality outcomes analysis and collaborate on monitoring and trending patient responses.
• Assess medication adherence and identify patients not meeting clinical goals, such as blood pressure or dietary targets.
• Advocate for disease prevention and healthy lifestyles to reduce inappropriate hospital stays and emergency department visits.
• Manage disease registries and follow up with patients who are not meeting evidence-based clinical goals.

What This Job Offers

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