Ambulatory Nurse - Primary Care - Bilingual English/Spanish

Employment Type: Full time Shift: Description: The Ambulatory Nurse serves as the clinical liaison between patients and the medical team, providing comprehensive support in an outpatient primary care setting. This role requires the ability to work independently, solve problems, and multitask effectively. Responsibilities include transitional care management, care coordination, patient triage, medication adherence promotion, and oversight of clinical quality measures to ensure exceptional patient care and practice performance. Key Responsibilities: Identify patients requiring preventive care, chronic disease management, laboratory tests, screenings, or referrals, and coordinate services to meet their needs. Perform transitional care management, including reviewing hospital discharge information, conducting medication reconciliation within two days of discharge, and scheduling follow-up appointments. Triage patient phone calls and respond to inquiries with clinical expertise, ensuring timely and accurate resolutions. Communicate test results to patients under provider supervision, offering appropriate guidance and next steps. Support medication adherence through patient education and follow-up communication. Accurately and efficiently document medical information in the electronic medical record system, maintaining compliance with documentation standards. Lead efforts to close preventive care gaps and monitor clinical quality measures, ensuring the practice meets all associated metrics. Promote best practices and contribute to the practice's success in achieving quality and operational goals. Qualifications: Active RN or LPN license. Bilingual English/Spanish preferred. Experience in primary care or ambulatory care is preferred. Strong communication, organizational, and critical-thinking skills. Skills and Attributes: Proficient in care coordination and transitional care management. Demonstrated leadership in quality improvement initiatives and closing care gaps. Ability to manage multiple tasks efficiently in a dynamic environment. Our Commitment to Diversity and Inclusion Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law. Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. Together, we’re 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, our system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations, and many other health and well-being services. Based in Livonia, Michigan, in fiscal year 2023, we invested $1.5 billion in our communities through charity care and other community benefit programs. For more information, visit http://www.trinity-health.org. You can also follow Trinity Health on LinkedIn.