Conduct transitional care management assessments, perform Annual Wellness Visits (AWV) in collaboration with a physician and assist in all quality nursing aspects of outpatient care.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).

2. Obtain certification in Basic Life Support within 30 days of hire date.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor's degree in Nursing (BSN).

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Performs Annual Wellness Visits (AWV) under the supervision of a physician. Elements of the Medicare Annual Wellness Visit include obtaining vital signs, screening for vision or hearing deficits, falls, cognitive impairment, depression, and performing a functional assessment, reviewing and updating patient medical and family history, medication reconciliation, and updating living will or Medical Power of Attorney documents

2. Focuses on prevention of illness and progression of co-morbid conditions through creating a prevention plan with the patient.

3. Schedules patients for AWV, runs quality reports, collaborates with clinic/office staff as well with physicians to implement change to practice to improve quality benchmarks.

4. Collaborates to perform outreach and assist in management of patients with many complex and co-morbid conditions

5. Educates and counsel patients concerning pertinent information for the medical condition. Prepares educational materials for patient use.

6. Contacts medical insurance companies to provide comprehensive medical information in order to obtain authorization.

7. Ensures all necessary testing and scheduling is complete prior to necessary procedures. Provides follow up to such.

8. Works in conjunction with health service coordinators to achieve all necessary prior pre-authorization, testing and scheduling is accomplished prior to necessary procedures or surgeries.

9. Provides specialized nursing assistance in quality, education, and research efforts.

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. The National Institute for Occupational Safety and Health recommends minimizing the need for employees to manually lift patients, and limit safe patient handling to 35 pounds. All transfers, lifts and re-positioning will be completed utilizing the lift equipment and/or other patient handling aids as indicated by the patient's profile and appropriate algorithms.

2. Heavy/Hard work: Work requires strength and/or stamina, lifting, moving, stooping, reaching, standing, walking, and carrying of materials and equipment weighing 35+lbs

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Working closely with others.

2. Working protracted or irregular hours.

3. Working around biohazards.

4. Working around infectious diseases.

5. Working with or near the deceased.

6. Working with hands in water.

7. Working with electrical hazards associated with patient care equipment.

SKILLS AND ABILITIES:

1. Working knowledge of procedures and techniques involved in administering routine and special treatments to patients.

2. Knowledge of and appropriate application of the nursing process.

3. Knowledge of professional theory, practice and procedure.

4. Ability to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership and other.

Additional Job Description:

Scheduled Weekly Hours:
40

Shift:

Exempt/Non-Exempt:
United States of America (Non-Exempt)

Company:
BMC Berkeley Medical Center

Cost Center:
8418 BMC University Internal Medicine

Address:
2500 Hospital Drive

Martinsburg

West Virginia