This position provides an integral role on an inter-disciplinary team whose purpose is to improve the ability of patients with chronic diseases to maintain and improve their health and avoid preventable hospitalizations and re-hospitalization. This position ensures continuity and coordination of care across transitions including hospital to home and will identify barriers and facilitate optimal care delivery including medical, pharmaceutical and social needs. This position is funded through a grant. PREREQUISITES: • Valid Pennsylvania RN license. • Valid Driver’s License and the ability to be covered by the company’s insurance carrier. • BSN preferred. ESSENTIAL JOB RELATED EXPERIENCE: • Experience in coordination of care for individuals with chronic conditions and complex medical and social needs. • Ability to work as part of a multi-disciplinary team with primary care physicians and other clinicians in a professional manner. • Ability to understand health care disparity issues and interact with patients and families of diverse cultural backgrounds. • Ability to adapt to evolving goals and requirements and to test new approaches to improved patient care. • Demonstrated effective positive verbal, written and interpersonal skills. • Ability to use independent judgment and compassion when carrying out tasks. • Ability to organize and prioritize work and work flow. • Experience with Microsoft Word and e-mail. • Experience working with Electronic Health Records. PREFERRED JOB RELATED EXPERIENCE: • Two years clinical experience in working in an ambulatory care setting. • Experience participating in hospital care transition improvement programs. • Experience working with database and patient registries.
Uniontown Hospital - 8 months ago