Up To $25,000 Sign On Bonus For Qualified RNs! Position Summary: The Heart Failure Care Coordinator is responsible for coordinating the evaluation and management of heart failure patients across multiple settings to include the Heart Failure clinic, primary care office, and inpatient settings using an outcomes‐based approach. In collaboration with other members of the healthcare team, the Heart Failure Care Coordinator will identify high‐risk/at‐risk patients, assist in developing a plan of care with the patient/family, and coordinate care with the patient’s involvement. Education, License & Cert: Bachelor’s Degree in Nursing or related field required. Master’s Degree preferred. CCRN preferred. Licenses The Care Coordinator, CHF must have or receive prior to position start date, current licensure by the Commonwealth of Pennsylvania and New York State as a Registered Professional Nurse, as required. Experience: A minimum of three (3) years relevant clinical experience, preferably in a cardiac setting, who demonstrates leadership and autonomy in nursing practice. Preferred two (2) years of heart failure experience. Heart Failure certification within 2 years of hire (CHFN or CHFN‐K through the American Association of Heart Failure Nurses). Essential Functions: 1. Support Care Management functions in the Heart Failure Clinic. a. Actively manages a panel of high‐risk/at‐risk patients with heart failure using motivational interviewing, shared decision making, and goal setting to increase patient/family engagement. b. Supports patients using technology, such as tele‐visits and remote monitoring c. Measures improvements in process and quality of care through evidence‐based guidelines and quality outcomes reporting. d. Collaborates with the Cardiology Care Team, patient, family, and other care team members to support the activities of the Heart Failure Clinic; and assess the management and progress toward goal attainment of patients with heart failure e. Provides follow‐up information for patients to ensure compliance with recommendations, medication, lab/x‐ray, specialist visits, PCP visits, dieticians, CDE, etc f. Participates in team‐based care during clinic hours. 2. Supports the CHF Remote Patient Monitoring program (RPM) a. Takes a lead role in the CHF Remote Patient Monitoring Program in collaboration with the program Director. b. Coordinates with the IT department to support department goals for program growth and development. 3. Is an active member of the Care Coordination team through participation on regular team meetings and regional Case Management meetings, as well as leading discussions and teachings to practice level staff on chronic disease management and high‐risk patient management. 4. Support Heart Failure Clinic through the use of technology, including Microsoft and EPIC Software. Functionality would include reporting Workbench, Patient Outreach (eGuthrie, Health Maintenance, Care Everywhere, EPIC Care Link) and Disease registry tools. Other Duties: 1. Travel for this position may be required. 2. Knowledge of the cardiovascular system and heart failure disease process. 3. It is understood that this description is not intended to be all inclusive, and that other duties may be assigned as necessary in the performance of this position. The pay range for this position is $31.00 - $47.86 per hour. Joining the Guthrie team allows you to become a part of a tradition of excellence in health care. In all areas and at all levels of Guthrie, you’ll find staff members who have committed themselves to serving the community. The Guthrie Clinic is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace. The Guthrie Clinic is a non-profit, integrated, practicing physician-led organization in the Twin Tiers of New York and Pennsylvania. Our multi-specialty group practice of more than 500 physicians and 302 advanced practice providers offers 47 specialties through a regional office network providing primary and specialty care in 22 communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and Orthopedic Surgery Residency, as well as Cardiovascular, Gastroenterology and Pulmonary Critical Care Fellowship programs. Guthrie is also a clinical campus for the Geisinger Commonwealth School of Medicine.