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Nurse Care Coordinator at Huggins Hospital

Posted in General Business 30+ days ago.

Type: Full-Time
Location: WOLFEBORO, New Hampshire





Job Description:

Under the general supervision of the Manager of Population Health & Care Coordination, is responsible for coordinating clinical care; educating; advocating; and assisting as the health navigator for patients in the Huggins Hospital Medical Practices. In addition, this position is responsible for assistance with data collection, analysis and reporting.
This is a full-time position working 40 hours per week.
Responsibilities
Patient Centered Care: - Participates in Patient-Centered team meetings - Participates in data collections, health outcomes reporting, clinical audits, and programmatic evaluation related to Patient-Centered Care Coordination initiatives
Direct Patient Care: - Facilitates health and disease management education - Supports patient self-management of disease and behavior modification interventions. - Provides comprehensive preventative wellness exams
Population Health & Quality Improvement: - Works with the Population Health Manager and IT on care opportunity reports to identify and address preventative care - Works to maximize opportunities for quality incentive payments from governmental and private payers related to population health and chronic care management - Provides data analytics and reporting for population health and disease management. - Participates in quality review, performance improvement, and medical practice patient satisfaction improvement initiatives
Care Coordination: - Coordinates continuity of patient care with patients and families following hospital admission, discharge, and ER visits - In collaboration with PCP, manages high risk patient care, including management of patients with multiple co-morbidities or those at high risk for readmission to a hospital setting - Promotes clear communication amongst a care team and with treating clinicians by ensuring awareness regarding patient care plans
Qualifications
Education: Graduation from an accredited school of Nursing
Experience: 2 years of experience in a clinical setting preferred, and 1 year in a Patient-Centered environment setting preferred. Experience in chronic disease management, utilization management, and adult acute care preferred.
RN/LPN State of NH
BLS (Basic Life Support) certification required





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