Nurse Care Coordinator
1 month ago
The West Side Federation for Senior and Supportive Housing, Inc. (WSFSSH) is a community-based organization whose mission is to provide safe, affordable housing with supportive services within a residential setting that enhances each person's independence and dignity. WSFSSH develops, manages, and provides housing for low-income older persons, many of whom live with mental illness and/or have experienced homelessness. WSFSSH is an Equal Opportunity Employer (EOE).
Under the direct supervision of the Euclid Hall Program Director and working collaboratively with the Social Services Team at Euclid Hall, the Nurse will provide a range of health coordination services to the residents of Euclid Hall to enable them to obtain and maintain safe and permanent affordable housing with as high a degree of independence as possible.
Responsibilities of the Nurse:
Care Coordination
The Nurse will assist residents in maintaining optimum health by:
• Observe and assess residents to assist in identifying any existing physical or mental health issues that need to be addressed and any changes over time.
• Ensure that high-risk residents are closely monitored and receive extra assistance with health education, care coordination, and follow-up (including scheduling and transport).
• Track high-risk residents’ healthcare compliance and schedule care coordination conferences as needed to incentivize their compliance and improve their health
• Serve as a primary point of contact between WSFSSH and the Federally Qualified Health Center located on-site; cultivate a mutual relationship of patient care coordination between the two parties
• Support residents’ efforts to obtain and maintain ongoing medical care by providing education regarding medication and medical treatments as needed.
• Provide workshops, training, activities, etc., to provide residents access to vital health, nutrition, and wellness information, including Wellness Self-Management.
• Coach WSFSSH’s site-based supportive services team members (including social work & medication staff) on best practices in healthcare coordination
• Coordinate and collaborate with a multidisciplinary internal and external care team to address and resolve resident medical needs.
• Train staff to ensure that medication information is available for scheduled medical appointments and in situations requiring emergency interventions and assist in obtaining medication information when needed.
• Provide emergency assessments and recommend emergency medical care as needed
• Assist residents and staff with hospital and nursing home discharge planning
• Assist staff with appropriate referrals, including but not limited to CCHA’s and home care agencies.
• Serve as a resource person to staff on issues related to resident medication and health issues, including reviewing and consult on client Rx profiles to reduce contra-indications
Medication Management
The Nurse will oversee the facility’s self-administration of medication policy by training and supervising WSFSSH’s on-site medication staff to:
• Support and observe residents’ self-administration of medication.
• Ensure that residents have adequate supplies of medications and assist in contacting providers for refills and new prescriptions.
• Adhere to infection-control policies and protocols, medication storage procedures, and controlled substance regulations.
• Ensure that up-to-date medication information is maintained in resident records.
Other Duties
• Provide crisis intervention services as needed
• Work as a member of a team to establish and maintain high level of care and respect for and communication with residents.
• Share information about resident progress, needs, and problems with other staff according to the WSFSSH Confidentiality Policy.
• Attend training sessions and conferences as required for enhancement of job skills
• Implement emergency procedures as necessary
• Submit all required reports in a complete and timely manner
• Assist with other duties as directed
Qualifications of the Nurse:
RN or LPN with1-3 years required experience in the profession
Current NYS license required
Experience working with individuals who have serious mental illness strongly preferred.
Experience training/supporting care team colleagues on effective client health coordination
Experience providing individual and group wellness education to clients
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