Staff Nurse (RN)
Federally Qualified Health Center
Division and Clinical Care Managers
Central City Integrated Health is committed to enabling every patient in our community to thrive by building a collaborative multidisciplinary healthcare team. The Staff Nurse provides care to patients/families, of all ages, in an outpatient setting by assessing, triaging, planning, and intervening in actual or potential health problems, including evaluating the patient's response to care. These responsibilities also include patient/family education and health maintenance strategies. The Staff Nurse is a member of a designated health care team and collaborates, coordinates and guides team members in planning patient care and achieving goals. He/She must demonstrate knowledge of the principles of human growth and development over the life span, as well as chronic disease identification and management and interpret data reflective of the patient's status to identify requirements relative to his or her specific needs.
Essential Duties and Responsibilities
1. Ensures timely and ongoing communication with the PCP and practice teams to identify high risk patients that are in need of special focus and to maximize the coordination of care to reduce associated health risks.
2. Ensures effective and efficient comprehensive transitional care management to ensure that processes are in place within the center’s workflow to prevent unnecessary readmission to the hospital and/or emergency room.
3. Provides follow up evaluation/medication reconciliation to patients seen in emergency room to prevent further disease exacerbation or additional unnecessary emergency room visits and/or hospitalizations.
4. Communicates with the patient, patient’s family, PCP and care team post hospitalization to manage follow-up care as appropriate.
5. Maximizes the effectiveness of patient office visits by reviewing care needs prior to the patient visit (chronic disease protocol; preventive health protocol; follow-up patient counseling/education needs).
6. Coordinates reviews of patient’s medication effectiveness with the medical team (adherence/patient understanding, expected impact and side effects).
7. Coordinates team huddles to plan visit objective(s).
8. Reviews lab results daily.
9. Assists patients in setting/maintaining self-management objectives; understands the correlation between physical health and behavioral health issues.
10. Recommends interventions to modify behaviors associated with health risks; collaborates with the patient to determine meaningful treatment goals.
11. Maintains knowledge of local community services (mental health; substance abuse; disability services; protective services; educational systems); effectively utilizes external services in planning patient care.
12. Assesses, plans and provides nursing care for children who are suffering from a wide variety of conditions including diseases, illnesses and/or are recovering from surgery.
13. Co-manages Vaccines for Children program; ensures proper ordering/stock, handling and recording of vaccine admissions; assists with vaccine administration for children and adults.
14. Must demonstrate an ability to remain calm and perform effectively and professionally during peak periods of activity and in emergency situations.
15. Maintains compliance with productivity requirements ensuring timely completion of documentation (within 24 hours of the kept appointment) and thorough and accurate coding of patient visits; failure to complete required documentation within 48 hours will result in unpaid administrative leave until all documents have been completed.
16. Educates and guides patients regarding disease promotion throughout the aging process; emphasizes appropriate preventative care screenings based on patient age, sex, race etc.
17. Provides health counseling and guidance individually or in group settings.
18. Participates in a multidisciplinary care team and identifies problems and provides feedback to team members regarding a solution.
19. Assists with the workflow of the clinic as needed.
20. Acts in a professional manner; demonstrates compliance with all policies, procedures and state/federal regulations.
21. Participates in the development of agency policies and programs to assure FQHC, NCQA, and other regulatory standards.
22. Ensures continuous flow of communication with the leadership team to enhance the quality of healthcare service to our patients.
23. Maintains economical and efficient nursing care in a clean and safe environment.
24. Takes part in performance improvement activities such as, quality assurance audits, continuing education, Patient Centered Medical Home processes, medication administration reviews, and peer reviews.
25. Participates in meetings/conferences and continuing education and demonstrates a genuine desire to develop strategies for improved clinic operations and high level patient care.
26. Ensures state licensure and national certification remain current and valid.
27. Assures consumers rights are being maintained at all times.
28. Participates in the integration of services including primary care, behavior health, dental services and supportive housing; serves as a resource to other providers and staff.
29. All other duties as assigned.
Qualifications and Skills
Must be available to work any and all hours scheduled. These include but are not limited to early mornings, evenings, and weekend hours as determined the organization and our patient population. Hours are subject to change based on need.
• Must possess knowledge, principles and practices of nursing
• Must be proficient with Electronic Medical Records including charting requirements of a RN
• Familiarity with coding (ICD-10) and determining level of service
• Critical thinking and strong problem solving skills
• Ability to initiate and maintain positive working relationships with CCIH staff and other organizations
Education / Experience
• Must possess a Bachelors of Nursing from an accredited school of nursing
• Must have a valid State of Michigan License as a Registered Nurse
• Minimum of 2 years nursing experience in an community based setting (FQHC or Integrated Care preferred)
• Must be able to work cooperatively with staff and others involved in the delivery of service to patients
• Must be comfortable with community outreach
• Basic Life Support certification
• Experience in managing multiple tasks simultaneously and meeting critical deadlines
• Must maintain confidentiality relating to treatment in accordance with HIPAA guidelines
• Knowledge of PCMH
Credentialing / licensure
SUBMIT RESUMES TO: T. Conte Human Resources
Central City Integrated Health
17950 Woodward Ave
Detroit, MI 48203
FAX NUMBER: (313) 733-1300