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Nurse Health Advisor Community Care Consortium 30 Min Lunch

Job ID: 2223
Facility: CHAPS Building
City: Greensboro

Date Posted: 2019-03-28 06:10:10 UTC
2018-07-12 17:40:25 UTC

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Job Description

LOCATION: CHAPS Building, Greensboro

JOB DETAILS:
Exempt: No
FTE: 1.0 (40 hours/week)
Schedule: 8 am - 5 pm
On Call: No

JOB SUMMARY:

A Health Advisor is a key member of the primary care team, serving as a clinical health advocate who works with a targeted group of patients to support the primary care team in such a way as to ensure physicians are operating at the top of their licenses while ensuring patients are receiving the preventive care they need. He/she will help individual patients resolve ambivalence and develop behavioral changes to improve health outcomes such as medication adherence and chronic disease management. He/she works toward improving overall quality metrics ratings by bringing members into compliance and closing gaps in care. The ideal candidate must be friendly, approachable and self-confident. He/she must have excellent verbal communication skills, an open-minded perspective to working with diverse populations, problem-solving skills, and a strong desire to help people as well as shape the future of healthcare.

EDUCATION:

Required:
Graduate of a Licensed Practical Nursing program, or BSN graduate of a Registered Nursing program required.
Would consider ADN graduate of a Registered Nursing program with a commitment to complete BSN within 3 years of hire.

EXPERIENCE:

Required:
3-5 years' experience as an LPN or entry level RN required. Experience providing patient education and/or health coaching preferred. An equivalent combination of education and experience may be considered.

LICENSURE/CERTIFICATION/REGISTRY/LISTING-REQUIRED:

Driver's License - NC DRIVER'S LICENSE

LICENSURE/CERTIFICATION/REGISTRY/LISTING-PREFERRED:

Preferred:
Certified Health Education Specialist or Certified Health Coach

MAJOR WORK ACTIVITIES:

Annual Medicare Wellness Visits (AMW): Identify patients who are eligible for a Medicare Annual Wellness Visit and educate these patients on the importance of these visits. Conduct AWVs. Refer patients to physician as appropriate. Completes and documents information in Electronic Medical Record (EMR). 25 %

Attends required meetings and participates in committees as requested. Participates in professional development activities and maintains professional affiliations. Functions as a member of the interdisciplinary team, providing updates on trends and outcomes to the provider. 10 %

Chronic Care Management (CCM): Identify patients who are eligible for CCM. Educate patients on the value of the CCM call and obtains patient consent. Assesses patient's background, resources and health issues and co-creates care plans around creating healthier lifestyles. Educates patient about health improvement and provides coaching for changing behaviors through strategies such as motivational interviewing and creating accountability. Develops plans, strategies and goals in partnership with the patient and helps the patient track adherence to treatment goals. Participate in face to face (F2F) visit with provider and patient. Help develop, in conjunction with providers, the patient's specific care plan. Conduct CCM calls. Data entry of assessments, care plans, and goals into EMR. 10 %

Gaps in Care: Provider Panel Management. Understands system quality improvement expectations (MU, ACO, and PCMH) and works to align the provider's panel with those metrics. Reviews and interprets provider level data on QI activities including evaluation of the effectiveness of interventions, adjusting plans as needed and presenting outcomes to provider and practice manager. Review and identify patients in need of screenings, tests, vaccines, and immunizations. Work with Care Guide and schedulers to schedule appointments for patients. Conduct visits to provide necessary screenings, tests, vaccines, and immunizations. Document appropriately in the EMR.20 %
Medication List Review and Verification: Collect and review pharmacy reports to determine whether patient is adhering to medication regimen. Work with patient to identify and resolve any barriers to their medication adherence. Reach out to polypharmacy patients 48 hours after visit to review medication regimen and ensure they received their medications. Review and verify list of medications and compare to EMR data, make changes and necessary. 15 %

Pre-Visit Planning: Identify patients who have an upcoming appointment, identifies gaps in care and conducts pre-visit planning calls with these patients. Initiate standing orders as appropriate. 10 %

Transitions of Care: Identifies Triad HealthCare Network (THN) and other at-risk patient populations who have been admitted to the hospital or ER and connects with those patients within 2 days in order to answer any questions and schedule a followup visit within 7 and 14 days of discharge. Performs follow-up visit for certain types of cases. 10 %

CONDITIONS OF EMPLOYMENT:
* Annual flu shot
* Annual TB test (if applicable to your job location)
* Annual HLCs (Healthstream, formerly CBL)-Safety at Work and CorporateCompliance
* Maintain licensure/certification/registry/listing (if applicable to your job)

ABOUT CONE HEALTH:
Cone Health is a state of the art network of facilities providing patientsaccess to the latest developments in medical care from their first moments oflife through later years. Our network offers the most breakthrough treatmentsand technology available in healthcare today. As a teaching hospital, we offeremployees the opportunity to become leaders in the industry and continuedgrowth from their first day on. Extraordinary patient care is about being"high-touch" as well as "high-tech". Community service and superior patientcare are the cornerstones of our organization, a philosophy that isdemonstrated by each and every one of our valued team members. We are proud tobe the largest private, not-for-profit employer of choice in the Piedmont, NCarea community. Additionally, as one of the region's largest and mostcomprehensive health networks, Cone Health has more than 100 locations,including six hospitals, three ambulatory care centers, three outpatientsurgery centers, four urgent care centers, a retirement community, and morethan 100 physician practice sites. Our tagline - "The Network for ExceptionalCare" - highlights our commitment to excellence, which is shared by our morethan 11,000 employees, 1,300 physicians and 1,200 volunteers.

Cone Health is an equal opportunity employer. If you require assistance withour online job submission process, please contact our Talent Acquisition teamat 866-266-3767 to request an accommodation.

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