Thrive by Three Title X Nurse Care Manager bei Greater Baden Medical Services

Job Summary:

The Thrive by Thrive by Three/ Title X Nurse Care Manager at Greater Baden Medical Services is responsible for providing ongoing support, case management and care coordination services, health education and referrals to link Thrive by Three/ Title X participants to community resources. The Thrive by Three Title X Nurse Care Manager provides support and services throughout pregnancy and during the first three years of baby's life. The Thrive by Three/Title X Nurse Care Manager promotes breastfeeding and, when necessary, will consult with WIC Breastfeeding Peer Counselor to provide breastfeeding services. The Thrive by Three/Title X Nurse Care Manager leads the Centering Pregnancy groups. The Thrive by Three/Title X RN will function as clinical resource to ensure that medical services are delivered in a safe and efficient manner, addressing patient needs expeditiously possible.

The Thrive by Three Title X Nurse Care Manager provides clinical support and collaboration to the Women's Health and Pediatric teams, reporting directly to the Ambulatory Care Nurse Manager and maintaining a dotted-line relationship with the Director of Programs.

Essential Job Functions:

1. Understands Patient Centered Medical Homes concepts and provides services to maintain PCMH recognition or accreditation.
2. Facilitates Centering Pregnancy groups in collaboration with medical providers and staff.
3. Routinely assess the educational needs of Thrive by Three/Title X clients who are at risk of poor pregnancy outcomes and/or family planning.
4. Develop a plan of care in coordination with Greater Baden medical providers based on needs identified through the risk assessment.
5. Assist clients in accessing community services and provide information and education to clients about smoking cessation, childbirth education, breastfeeding support, parenting and infant growth and development.
6. Conduct client satisfaction surveys as related to Thrive by Three Title X guidelines and protocols.
7. Performs care management services for individuals/families receiving Thrive by Three/Title X services.
8. Assist in completion of interim quarterly reports.
9. Maintains medical supplies and inventory for Title X program.
10. Educates CMAs on Title X duties. 
11. Works with Intake Coordinator to refer participants to Greater Baden programs and services for additional education and support, including WIC, Dental, and on-site DSS services.
12. Prepare and facilitate patient education through individual appointments, or group sessions.
13. Serve as facilitator for required Title X patient education.
14. Actively serves on the Title X Advisory Committee.
15. Directs efforts toward identifying specific needs of clients enrolled in the program, to assure timely and appropriate services to promote positive outcomes.
16. Communicates and collaborates with a multidisciplinary healthcare team.
17. Make internal or external appointments for patients.
18. Coordinates the care of the patient with external healthcare providers and other community resources.
19. Document the patient's medical, behavioral, psychosocial concerns in the medical record and works to improve the patient's health status.
20. Completes post-partum encounters to obtain delivery information, link newborns to pediatrics, and provides health education as appropriate.
21. Participates in external meetings with local health department documenting relevant information regarding their interests, involvement, impacts heavily on program and project success.
22. Provides triage service in person or over the telephone.
23. Provides health teaching and counseling to patients and families. This may include communication test results, medication changes, etc.
24. Provides direct nursing care to patients, including performing assessments, nursing procedures (including injections), and assistance with procedures.
25. Offer medication reconciliation and adherence counseling while assessing patient knowledge and addressing barriers to adherence and self-care.
26. Assesses patient requests for same day services and works with Providers and Center Manager to ensure that patient needs are addressed appropriately.
27. Expedite patients flow through the implementation of standing orders or policies for medication refills, referrals, and immunizations. Ensures that clinical medical assistants are familiar with standing order protocols and follow them appropriately. 
28. Participates in the immunizations process, including inventory and record keeping.  Ensures that vaccines are stored properly. Oversee immunization administration process and educate staff regarding proper technique and current recommendations. Has knowledge of the Vaccines For Children program and assists with compliance. 
29. Oversee laboratory services, including review of quality control, oversight of inventory and record keeping. Ensures that supplies are stored properly. Supervises specimen collection process and in-house testing and. Educates staff regarding proper technique and current recommendations.
30. Participates in the maintenance of medication and medical supply inventory, including monthly expiration process. 
31. Provides clinical training to medical assistants and supervises competency evaluations as directed by the Ambulatory Care Nurse Manager.
32. Demonstrates proficiency in the use of the EMR and serves as a clinical resource.
33. Completes all other duties as assigned.

Nonessential Functions:

1. Participates in team/staff meetings; attends service meetings and applicable workshops.  
2. Performs other duties as assigned. 

Core Values: Core Values: Quality Respect Teamwork Equity Integrity Passion Love

Minimum Qualifications

1. Current Registered Nursing License in the State of Maryland required.
2. Bachelor’s degree in Nursing or Associate’s Degree in Nursing 
3. Current Cardiopulmonary Resuscitation Certificate (CPR).
4. OB/GYN experience in a outpatient or inpatient setting.
5. Bilingual is a plus!
6. Pediatric experience is a plus!

Substitutions- None

Core Competencies Needed

Problem Solving – Identifies and resolves problems in a timely manner; gathers and analyzes information skillfully, develops alternative solutions; works well in group problem solving situations; uses reason even when dealing with emotional topics. 

Communication Skills - Listen and verbally to solve problems and provide information and direction, ensuring the experience is a positive one. Record issues and resolutions to maintain accurate records and data for further analysis by management. 

Analytical Skills - The ability to tackle a problem by using a logical, systematic, sequential approach. Possess creative thinking, learning, systems thinking and problem solving. Must be effective at defining and solving problems to ensure that the real, underlying challenge is understood and that solutions actually address it.

Healthcare Systems - Knowledge of healthcare and medical terminology.

Risk Management/Compliance - Confidentiality principles and laws, maintain compliance with government contractual mandates.

Work Environment

This job operates in an outpatient office environment.  

Physical and Mental Demands

1. Ability to cope with stress. 
2. The person in this position needs to occasionally move about inside the center. 
3. Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine and computer printer. 
4. The person in this position frequently communicates with patients and/or employees. Must be able to summarize and exchange accurate information.
5. Must be able to lift or assist moving a patient weighing more than 50 pounds in the event of emergency. 
6. Performs with frequent interruption or distractions.
7. Adjust priorities quickly as circumstances dictate. 
8. Cognitive ability to analyze, count, summarize and synthesize information from multiple sources. 

Language Skills

Ability to read and interpret written or verbal documents and instructions. Ability to speak effectively to patients, employees, and/or stakeholders of the organization. 

Travel

Must be able to drive between Greater Baden Medical Services, Inc. locations.