Northern Light Health Department: Care Coordination Position is located: Mercy Fore River Work Type: Full Time Hours Per Week: 40.00 Work Schedule: 8:00 AM to 4:30 PM Summary: Oversee clinical care to patients with complex care needs, chronic disease and through transitions of care. Serves in an expanded nursing role to collaborate with the Medical Team to provide a model of care that ensures the delivery of quality, efficient, and cost effective healthcare services. Integrates evidence based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare. Reports to: Regional Manager, Care Coordination for Beacon Health, LLC. Responsibilities: • Manage utilization and practice metrics to refine the delivery of care model to maximize clinical, quality and fiscal outcomes for the population • Monitor patient progress and promote early intervention in acute care situations • Provide safe transition of care across the continuum of care • Provide patient education • Promote patient independence and self-management • Demonstrate autonomy being accountable for their practice • Demonstrate the ability to negotiate and influence individual and group decision- making. • Adapt to a fluid, dynamic and rapidly changing environment. • Demonstrate leadership qualities in the areas of time management, problem solving, decision making, priority setting, delegation, organization, written/verbal communication and listening skills. • Works with Beacon Health leadership in the design, implementation and evaluation of the Medical Home care model. • Implement monitoring systems for high-risk member to prevent and/or intervene early during acute exacerbations. Works with the primary care physician to ensure appropriate standing orders for acute exacerbation management (such as diuretic titration protocol). • Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population. • Provides regular progress updates to PCP and other members of the care team. • Collaborates with the Inpatient and Continuing Care Coordinators to ensure smooth process in place when movement between settings occurs. Other Information: BLS Certification. Competencies and Skills + 3+ years of relative work experience required. + Achieves Results: Sets high standards for their own outcomes and seizes opportunities to engage others towards objectives. Consistently moves forward with direct actions in order to attain or exceed objectives. Manages their own time effectively to accomplish assigned tasks. Successfully prioritizes multiple projects and duties as needed. + Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan. + Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation. + Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively. + Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit. + Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level. + Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved. + Influences and Inspires: Builds enthusiasm and commitment among others to move in a desired direction and models it personally. Creates a compelling vision of success that motivates workplace initiative and energizes others to follow. Provides direction and guidance to encourage cooperation between team members in order to attain an objective. Has the ability to appropriately influence others' actions and decisions with and without express authority. + Word processing, spreadsheets, data entry, database experience and other computer related skills. + Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others. Credentials + Required Registered Nurse Education + Required High School Diploma/General Educational Development (GED)Bachelor's degree in Nursing preferred Working Conditions Position Care Manager- RNLocation Req ID null