Registered Nurse Population Health

In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always. 

Work Shift:

Scheduled Weekly Hours:

Department:

Overview of Position:

ESSENTIAL DUTIES
1.    Provides direct patient care in accordance with physician orders in a warm and friendly manner.
2.    Takes and records measurements or readings.
3.    Assesses condition and provides treatment for care of patient.
4.    Administers prescribed medications.
5.    Provides leadership while working collaboratively with other care givers on the unit.
6.    Serves as a resource person for other staff throughout the hospital and community regarding cardiovascular diagnostics and rehab.
7.    Conducts pre-visit chart review of patients including: Identification of all needed preventive health maintenance, immunizations, and chronic disease interventions; when standing orders allow, interventions ordered or completed before the patient sees a provider; fills out pre-visit forms or initiates office visits forms to communicate the review to the provider.
8.    Works with patients and families on self-management support including: setting short and long-term goals for self-management of chronic disease; addressing medication adherence in patients not meeting outcome goals; works with patient to create a plan for Health Behavior Change utilizing the 5A’s approach assessing and working on the patient’s readiness to change, the importance of change, and confidence in ability to change, helping the patient to identify and overcome barriers; makes a plan for follow-up between visits; provides or arranges needed patient education regarding specific health care skills and general disease concepts; assisting with shared medical appointments; communicating face-to-face in the office setting, by telephone, or by e-mail.
9.    Coordinates with others across the care continuum including: assisting as liaison with patients and their families to physicians, clinical staff, and other departments; acting as a liaison with hospitalized patients, navigator and the clinic. Following up with patients by phone shortly after hospital discharge; acting as a liaison with specialty clinics; proactively acts as patient advocate, responding to and working to resolve patient concerns; and providing a link to community resources. 
10.    Involvement in QI activities: communicates and coordinates with the healthcare team (including management, providers and other MCI population health nurses if applicable) in the development of tools for optimal patient outcomes and report findings.
11.    Assists NP in overseeing the disease registry database including: assuring database is kept up to date and identifying patients overdue for visits, labs, or referrals and arranging for follow-up services as appropriate; Identifying patients not meeting clinical goals, such as BP control or glucose control, and arranging for follow-up services by protocol or as appropriate; creating patient, physician, and clinic level quality performance reports.

QUALIFICATIONS
1.    BSN or Bachelor’s degree in a health-related field and current Ohio RN License.  
2.    Certified Health Coach (or comparable certification), or obtained within two (2) years of hire.
3.    Three (3) years experience in a defined outpatient clinic setting, acute care setting, or combination.
4.    Current CPR certification or obtain within 30 days of employment; current ACLS or obtain within 90 days of employment.
5.    Ability to read, write and explain or describe moderately complex information to other hospital staff.
6.    Attention to detail with ability to collect data, interpret findings, set priorities and carry out established plan.
7.    Ability to communicate well in an oral and written manner, as well as the ability to observe, assess, guide, and evaluate others.
8.    Ability to read, calculate and prepare medication, and ability to observe/analyze any resulting reactions and to apply clinical knowledge.
9.    Ability to demonstrate competence in age-specific patient care. 

PATIENT CENTERED CARE & BEHAVIORAL EXPECTATIONS
1.    Living the Genesis Mission, Vision and Values
• Performs work in a manner that is quality focused.
• Treats patients, co-workers, visitors and volunteers with courtesy, compassion, empathy and respect.
• Results oriented and focused on achievement of objectives.
• Acknowledges and responds to the diversity of people and the situation.
• Encourages peers (others) to be owners of change.
• Always makes the effort to anticipate and exceed customer needs and expectations.
• Possesses the ability to engage others with patience and understanding.
• Acts in a manner that creates positive first and lasting impressions.
• Demonstrates the ability to own issues until they are resolved.
2.    Patient Centered Care  (patients/families, physicians, co-workers, all other internal/external customers)
• Introduces self and role…connects with everyone.
• Communicates effectively (i.e. advising others of actions, pertinent information, time durations, etc.) and asks for feedback.
• Asks for and anticipates needs and concerns of others.
• Maintains a positive work environment for staff and a healing environment for patients (i.e. safe, clean, quiet, etc.)
• Maintains the dignity and privacy of each person; manages confidential/sensitive information appropriately.
• Responds to requests in an appropriate and timely manner.
• Exits patient/customer encounters courteously, asking if there are additional needs that can be addressed.
3.    Promotes Patient and Employee Safety 
• Demonstrates safe Patient Handling (i.e. transfers, transport, care administration, nutrition, medication, etc.) 
• Demonstrates safe Materials Handling (i.e. appropriate use and disposal of chemicals, infectious wastes, etc.)
• Demonstrates appropriate knowledge of Infectious Disease precautions and use of proper protective equipment
• Demonstrates Slips/Trips and Falls Awareness.
• Actively contributes to maintaining a safe, clean and quiet environment.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

1.    Ability to sit, stand, stoop, push, pull, bend, and walk for extended periods of time
2.    Ability to lift 50 pounds to waist level
3.    Ability to communicate well in an oral and written manner, as well as the ability to observe, assess, guide, and evaluate others
 
This description reflects in general terms the type and level of work performed.  It is not intended to be all-inclusive, nor portray the specific duties of any one incumbent.