Medical Nurse Case Manager

1 month ago

Hyannis, Massachusetts, United States Cape Cod Healthcare Full time
  • Performs initial intake assessment and orientation for new HIV/AIDS patients to the program. Performs patient benefits eligibility screening and assists patients with enrollment in appropriate programs such as: HDAP/CHII, Health Safety Net, Ryan White Early Intervention Services, Pharmacy Assistance Programs, and Medicaid/MassHealth. Initiates referrals for food/housing/transportation assistance, substance abuse treatment centers, and MDPH partner notification services.
  • Serves as a medical nurse case manager/patient care coordinator. Provides for continuity of effective patient and family care by acting as a liaison/communication link between the Infectious Disease team and staff of substance abuse agencies, correctional institutions, specialty offices, visiting nurse associations and local AIDS service organizations.
  • Provides one-on-one HIV pre and post test counseling to patients requesting HIV testing. Obtains HIV test counselor certification; maintains certification by attending HIV continuing education programs.
  • Works with providers (MD/NP) in supporting adherence education to all patients on HAART. Develops tools and educational materials for patients, families and significant others.
  • Tracks high-risk populations through systematic data collection and analysis. Responsible for collection of clinical data needed for MDPH, HRSA and other funding source reports, as identified by the Program Director. Collaborates with the IDCS team in the development of policies, procedures, and record keeping forms and other data gathering forms necessary for the program.
  • Participates in Infectious Disease team quality management projects. Able to identify areas of concern for future quality management projects; serves as project leader when appropriate.
  • Attends conferences, meetings and training specific to infectious disease to maintain a high level of clinical and prevention/public health knowledge.
  • Develops nursing assessment based on data collection. Obtains a nursing history utilizing the patient, family, medical record, professional staff, community agencies and other departments. Interviews patients and families to gain ideas, feelings and facts that identify their needs and goals. Observe overt and covert signs and symptoms in a systemic way. Identify and record physical, social and psychosocial needs of the patient and family.
  • Responds appropriately in emergency patient care and related situations. Implement appropriate intervention based on an ongoing assessment of patients.
  • Records and reports pertinent data on patient medical record and to appropriate health team members. Evaluates data obtained in the nursing assessment in making knowledgeable interpretations. Differentiates nursing situations that require priority setting and responds accordingly. Recognizes teaching and learning needs of patients and families. Coordinates teaching plan. Provides individual or group patient education and counseling.
  • Assists the provider in developing measurable short and long-term goals, which are patient centered and derived from the medical diagnosis. Involve the patient and family in goal setting and individual plan of care.
  • Serves as patient advocate. Defends and preserves the rights of patients pertaining to all aspects of their care, knowledge and privacy.
  • Assists the provider in initiating referrals and utilize available resources outside the facility for the purpose of comprehensive care to patients and families.
  • Demonstrates flexibility when responding to change. Assumes accountability for all actions. Contributes to orientation of new nursing and medical assistant personnel. Responds appropriately to facility acuity and activity by providing assistance to peers, patients and staff as needed.
  • Administers immunizations and treatments and performs diagnostic test as ordered by provider including, but not limited to: EKG's, hearing and vision tests.
  • Maintains patient areas to provide for a safe, sanitary, and therapeutic environment.
  • Able to demonstrate the knowledge and skill necessary to manage and provide the care appropriate to the ages of patients served. Must be able to provide the care needed as described in the policy and procedure manual.
  • Assists the provider with procedures as directed. Triage patient phone calls; assess and determine the need for immediate medical care based on urgency of problem. Process refills of medication based on facility protocol.

Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Hospital's commitment to CARES: compassion, accountability, respect, excellence and service.
  • Registered Nurse with current Massachusetts license required.
  • BSN required.
  • Minimum 2 years clinical nursing experience required.
  • 1-2 years experience working in an outpatient HIV/AIDS disease management program OR 1 – 2 years experience in a substance abuse, mental health or correctional institution required.
  • Proven strong collaborative, organizational and interpersonal skills required.
  • Massachusetts Department of Public Health Office of HIV/AIDS training series required within 6 months.
  • Electronic data collection, data entry and analysis skills required.
  • CPR certification required.
  • Fluency in Portuguese strongly preferred.

Purpose of Position

To provide patient medical case management services for IDCS.

Schedule Details

40/32 Flex Hrs per week, Monday-Friday, 9a-5p, no weekends or holidays. The flex day will depend on operational need.

Organization

Cape Cod Hospital

Primary Location

Massachusetts-Hyannis

Department

CCH-Infectious Disease

Employee Classification

Regular-Regular

Shift

Day

Weekend Shifts

None

Holiday Shifts

None

Posting Start Date

Jul 31, 2024

Posting End Date

Ongoing

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