RN SCO

NeighborHealth•Boston, MA

1d•$44 - $64•Onsite

About The Position

NeighborHealth, formerly East Boston Neighborhood Health Center, is a large community health center serving the greater Boston area with a commitment to patient and community health. This full-time Nursing position is in the Senior Care Options Department (SCO), focusing on direct patient care and education. The role involves facilitating initial enrollments into the SCO Program and coordinating care with various departments (nursing, case management, social workers, rehabilitation) for Skilled Nursing Facilities. The SCO nurse case manager acts as a liaison between the patient, their family, and healthcare personnel to ensure efficient and prompt health care services, minimizing fragmentation and duplication. Care plans are developed collaboratively with other SCO team members, considering both medical necessities and psychosocial needs to implement cost-effective plans. Nurses work with patients and families to align healthcare wishes with the goal of maintaining independence and safety in the community. Responsibilities include controlling health center resources and home services through periodic care plan reviews, maintaining continuity of care between home, health center, and hospital, and providing nursing-centered office and home visits. Excellence in this position also involves demonstrating a comprehensive understanding of the department’s immediate needs and long-term growth goals.

Requirements

MA RN license
Minimum one year working with geriatric population
Graduation from an accredited nursing program
RN licensure in Massachusetts
BLS certification
At least one year of relevant nursing experience in a community health and/or ambulatory care setting preferred
Demonstrated ability to communicate effectively verbally and in writing
Familiarity with Windows operating system preferred

Nice To Haves

Community Health or nursing home experience preferred
Bilingual skills preferred

Responsibilities

Performing direct patient care and patient education in the Senior Care Options Department (SCO).
Facilitating initial enrollments into the SCO Program.
Coordinating care with nursing, case management, social workers, and the rehabilitation department for Skilled Nursing Facilities.
Acting as a liaison between the patient, their family, and healthcare personnel to ensure efficient, prompt health care services and to minimize fragmentation and duplication of services.
Developing care plans for SCO patients, addressing both medical necessities and psychosocial needs in collaboration with other SCO team members.
Working closely with patients and their families in creating a care plan to adjudicate the patient’s wishes for health care with the goal of maintaining independence and safety in the community.
Controlling health center resources and home services through periodic reviews of the care plan.
Maintaining continuity of care between home, health center, and hospital.
Providing nursing-centered office visits and home visits.
Demonstrating a comprehensive understanding of the department’s immediate needs and long-term growth goals.