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Complex Care Nurse
2 months ago
Harbor Health Services is an innovative, growing, mission-based organization that lives, serves and collaborates with our community members to achieve our mission to help individuals reach their full potential through access to local, affordable services that promote health. Harbor provides medical, behavioral health, dental, and support services to more than 34,000 patients in Boston, the South Shore, and Cape Cod. Harbor Health also operates two Programs for All-Inclusive Care for the Elderly in Mattapan and Brockton and a WIC Nutrition Program. To help further the mission of Harbor, we are looking for a talented Complex Care Nurse to join our Family Practice Dept. at the Harbor Community Health Center-Plymouth.
Our position is offered with a GREAT Benefits Package including Health, Dental and Vision, Life and Disability Insurance, generous paid time off plus an additional 11 paid holidays annually, parking on site and competitive salary
Student loan repayment opportunities (National Health Service Corps/Nurse Corps, Public Service Loan Forgiveness and State Programs) available at our health center sites FOR MORE INFO CLICK HERE: Nurse Corps Loan Repayment
Role:
The Complex Care Nurse provides nursing services at the top of the incumbents license to patients in accordance with all applicable Massachusetts State Laws as well as regulations promulgated by the Department of Public Health and Harbor Health Services, Inc. The Complex Care Nurse ensures our High-Risk Patient population (primarily our Substance Use Disorder (SUD) program patients) are properly managed including, referrals, consults, tests, medication management, and patient education to ensure or move toward optimal wellness. Hours are Monday through Friday, 8:00 AM - 4:00 PM, no weekends, no evenings
Responsibilities:
Ensures High Risk Patient population (Substance Use Disorder (SUD) program patients, Complex Care) is properly managed including, referrals, consults, tests, medication management, and patient education to ensure or move toward wellness.
Ensures High Risk Patients have a completed care plan and documents in the EMR.
Acts as Health Educator for Complex Chronic Disease population (HIV, Hep C etc.)
Completes at least 16-20 scheduled patients facing clinical hours per week of individual or group visits.
Assists providers and Care Team members in caring for patients and acts as liaison between the patient and the care team. .
Performs routine nursing care to patients, while utilizing age specific guidelines and standard precaution practices at all times.
Performs patient teaching for all patients and families.
In conjunction with team and/or provider, assists in the development and implementation of a comprehensive plan of care.
Assists providers with on-going assessments and evaluates needs and interventions based on the current status adjusting the care plan as required assuring compliance and understanding of the long-term plan.
Communicates with all staff, patients, and families demonstrating excellent written and verbal skills.
Maintains knowledge of all medications, reactions, documentation, and dosage requirements.
Triages patients as needed.
Supports transitions of care through nurse visits after ED/Hospitalizations as appropriate.
Actively participates in the manual and automated clinical tracking programs to ensure compliance with clinical outcome measures, prevention and follow-up care.
Requirements:
Current MA Registered Nurse (RN), current BLS Certification required, BSN preferred
2-5 years of experience working with Substance Use Disorder patients highly desired
Excellent customer service and verbal and written communications skills
Ability to effectively work within both a team setting and independently
Ability to work effectively with economically, racially and linguistically diverse customers, bilingual (Portuguese or Spanish) a plus
Intermediate computer literacy (Microsoft Office 365 Word, Excel, Outlook and Teams), experience with EMR (EPIC/OCHIN desired)
Experience in a ambulatory and/or community health setting and experience in medical case management in acute care preferred.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
*$2500 on hire and $2500 after 90 days in good standing for Benefit Eligible hires, former employees of Harbor Health not eligible.
Monday through Friday 8:00 AM - 4:30 PM
No weekends/no evenings
Full Time 40 hours
