Essential Functions

Coordinates the clinical care of patients being evaluated for and/or patients already participating in the clinical program, including research activities, and education.

Demonstrates the knowledge and skills necessary to provide care, or arrange for the provision of appropriate care for an adolescent, adult, or geriatric population of patients.

Demonstrates knowledge of the principles of growth and development over the life span and possesses the ability to assess data reflective of the patient's status. Interprets the appropriate information needed to identify each patient's requirements and ensures and documents that age specific needs are being met as described in the departmental policies and procedures.

Coordinates clinical care throughout the program utilizing pathways and developing tools to ensure high quality, cost effective continuity of care is provided to all patients.

Collaborates with other clinical team members in assessing and supporting psychosocial needs of the patient/family.

Supervises and coordinates the program interdisciplinary care conferences as applicable.

Collaborates with entire clinical team to evaluate and implement appropriate educational materials.

Physical Requirements
Requires ability to sit, stand, or walk for long periods of time. Reaching, stooping, bending in file drawers. Working in fast-paced clinical setting. Intact sense of sight, hearing, smell, and touch and manual and finger dexterity. Must be able to be mobile within the entire healthcare system as needed.

Education, Experience and Certifications

BSN required. MSN preferred. applicable state RN license required. 2 years nursing experience required. Program management experience preferred. 5 years experience preferred. BLS required per policy guidelines. Depending on specialty area, a valid applicable state driver's license and reliable transportation may be required

Licensure, Registration, and/or Certification RequiredRegistered Nurse license issued by the state in which the team member practices.

Education Required:

Bachelor's Degree in Nursing.

Experience Required:

Requires 5 years of experience in quality improvement experience in a healthcare environment

Must have strong Quality Experience

Experience working on Heart Failure, Sepsis, Stroke

Knowledge of Quality Tools

Understand and has worked with Get with the Guidelines

Knowledge base in Process Improvement

(A3, PDSA, Rapid Cycle Improvement)

Data analysis and management

Experience in detailed medical record reviewPolicy & Procedure DevelopmentRegulatory Compliance knowledge

**Certification in Healthcare quality preferred but not a requirement 

90% work is focused on nursing practice/documentation

Knowledge, Skills & Abilities Required:

Advanced knowledge of regulations and standards for health plan administration accreditation/delegation.Demonstrated leadership abilities to include project/staff coordination. Experience with planning and implementing complex projects.Strong written and oral communication skills with ability to concisely communicate with key leaders. Ability to establish goals, priorities, and ensure team members understand work assignments.Highly motivated, organized, self-starter with a focus on delivery of key project objectives.Demonstrated effective interpersonal skills and evidence of being a strong team player. Possesses a strong orientation toward customer service, innovation and new ideas.Strong facilitation and persuasion skills; capable of influencing project team members to achieve goals.Ability to work and remain flexible in a dynamic environment with multiple dependencies, departments and projects. Ability to set priorities and accomplish assignments in a thorough and timely fashion.Demonstrated knowledge of the evolving health care delivery environment, health claims processing, medical management, and the health plan sales process.Proficient knowledge in the use of Microsoft Office (Excel, PowerPoint and Word) or similar products.

Physical Requirements and Working Conditions:

Must be able to perform fine hand manipulation when using computer keyboard.Exposed to a normal office environment the majority of the time.Position requires occasional travel. May be exposed to road and weather hazards.Operates all equipment necessary to perform the duties of the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.