POSITION SUMMARY:
Adhering to System Values, Service Excellence, and Standards of Behavior, the Ambulatory Clinic Office Registered Nurse provides safe, high-quality nursing care to adult and pediatric patients in an outpatient setting. This role applies the nursing process to assess patient needs, perform patient-care-related tasks, administer ordered injections and vaccines, perform and monitor anticoagulation-related testing, provide patient education within a nurse's scope of service, and coordinate follow-up care in collaboration with providers and the interdisciplinary care team. The nurse ensures accurate documentation, supports adherence to established protocols and standards of practice, and promotes a patient-centered environment focused on safety, quality, and continuity of care.

The anticipated hourly range for this position is $39.22/hr - $49.02/hr - $52.94/hr. Final compensation will be determined based on the selected candidate's applicable experience, skills, qualifications, and other job-related factors.

ESSENTIAL QUALIFICATIONS
Education:
• Associate of Science in Nursing (ASN) from an accredited institution.
• Bachelor or Master's degree in Nursing or Healthcare Management preferred.

Certification:
• All employees and contracted staff will have either successful completion of an American Heart Association* accredited course in Basic Life Support (BLS), or ACLS and PALS combined. (for clinical staff), Heartsaver CPR AED (for nonclinical staff), and renewal on a regular basis.
*Refer to the NCH Life Support Certification Policy for position-specific requirements.

Licensure:
• Current Registered Nurse (RN) license in the state of New Hampshire and Vermont required.

Skills:
• Excellent communication and interpersonal skills.
• Ability to prioritize and manage multiple tasks efficiently.
• Proficiency in electronic medical records (EMR) systems.

Work Experience:
• Understanding of CPT, ICD-10 and HCPCS coding and its relationship to billing preferred

ESSENTIAL FUNCTIONS:
1. Assesses, monitors, and documents each patient's clinical status, nursing interventions, education, and follow-up needs in the electronic medical record.
2. Coordinates daily operations of the Ambulatory Nurse Clinic, including workflow, schedule preparation, resource needs, and communication priorities.
3. Manages patient communications, including phone calls, voicemail, and clinical messages, to ensure timely response and continuity of care.
4. Performs ordered clinical procedures within nursing scope of practice, including injections, wound care, blood pressure checks, ear irrigation, and outpatient EKGs.
5. Coordinates referrals, specialty services, IV medication arrangements, pre-operative orders, and related patient care activities according to established protocols.
6. Provides patient education and counseling on medications, chronic disease management, insulin use, blood pressure control, injections, vaccines, and anticoagulation therapy.
7. Performs, reviews, and documents PT/INR testing and collaborates with providers to support safe and effective anticoagulation management.
8. Educates patients receiving anticoagulation therapy on dosing instructions, diet considerations, medication interactions, bleeding precautions, and follow-up requirements.
9. Monitors INR results across care settings and coordinates timely follow-up, confirmatory testing, and outreach for patients overdue for testing or appointments.
10. Manages Warfarin refill requests and evaluates medication adherence, including pill counts, discrepancy documentation, and escalation of concerns as appropriate.
11. Prepares and administers allergy immunotherapy injections in accordance with provider orders, patient verification requirements, monitoring standards, and documentation protocols.
12. Prepares and administers adult and pediatric vaccines according to standing orders and clinical guidelines, including screening, education, monitoring, and documentation.
13. Provides triage support for anticoagulation, medication management, injection-related concerns, and other outpatient nursing needs, coordinating follow-up care as indicated.
14. Supports telemedicine clinic operations by coordinating scheduling, laboratory needs, patient preparation, visit communication, and clinical support during appointments.
15. Maintains clinic readiness and program quality through inventory management, anticoagulation record oversight, monthly reporting, billing coordination, infection control practices, safety protocols, team participation, and quality improvement activities.
16. Performs additional duties as assigned.