Demo

Care Management RN- Full time

Grace Cottage Hospital
Townshend, VT Full Time
POSTED ON 2/2/2025
AVAILABLE BEFORE 3/2/2025
Description

Position Summary:

The Care Management RN is responsible for managing patients, including those who are considered high risk patients to promote effective education, self-management support and timely healthcare to achieve and improve quality and outcomes. Acts as an advocate for the patient’s needs and fosters patient engagement and adherence to plan of care based on evidence based clinical objectives.

Qualifications

Education/ Experience:

  • Graduate of accredited school of nursing
  • Registered Nurse licensure in Vermont
  • 3-5 years’ experience in primary care and/or emergency department, preferred

Other Requirements

  • Current Basic Life Support certification
  • Excellent critical thinking and judgement skills
  • Excellent customer service skills
  • Experience with Electronic Medical Records Systems

Requirements

Essential Functions Of The Position:

  • Responsible for coordinating the care of patients with or at risk of chronic conditions
  • This position will also provide direct services to patients and/or families in understanding and adapting to the realities imposed by illness, as well as intervention and plan of care to meet social/health needs in coordination with providers and multidisciplinary team utilizing available community resources
  • Provides direct services to patients and/or families; conducts and documents interviews with patients and intervention (care plan) efforts; conducts psychosocial and clinical-related assessments to identify gaps; utilizes/refers to community resources as necessary; offers emotional support in relation to health/social needs and plan of care at home; assists with end-of-life care planning, advanced directives, or other services, and arranges for nursing facility and rehab center care and other healthcare organizations as needed.
  • Coordinates transition of chronic care for patients between hospital, nursing home and outpatient services
  • dentifies barriers and finds solutions to resolve the barriers
  • Provides educational resources specific to the patient’s health needs, utilizing written materials, video materials, group information, and/or web-based education modules
  • Works with the providers, clinical team, and leadership to champion quality-improvement initiations in the practices by using clinical information to identify clinical areas for improvement
  • Provides short-term case management for patients with complex medical needs
  • Provides medication-specific teaching as needed
  • Provides targeted clinical education for a variety of chronic diseases
  • Responsible for collaborating with providers to identify patients with chronic diseases who would benefit from care management services
  • This role requires effective communication and consultation skills, as well as the ability to prioritize multiple tasks simultaneously
  • Conduct initial and periodic holistic assessments for chronically ill patients
  • Develop and implement personalized care management plans based on assessment findings
  • Provide consultation and support to patients and their families regarding identified health issues and concerns
  • Conduct medication reconciliations for patients discharged from the hospital or after office appointments

How We Support You

  • Rich Medical, Dental and Vision Insurance
  • 401(k) with matching
  • Life And Disability Insurance
  • Tuition and Loan Reimbursement
  • Generous Earned Time Off Package
  • Responsive Employee Assistance Program
  • Wellness Motivations And Incentives

Why Grace Cottage?

Grace Cottage has been voted “Best Place To Work,” in the Brattleboro Reformers Readers’ Choice Award since 2019. We are also included in the Vermont Biz Magazines 2023 & 2024 Best Places To Work in Vermont! Who wouldn’t want to work in a small hospital in VT with these accolades. Grace Cottage is surrounded by beautiful mountains to ski/snowboard/snowshoe, stunning hiking adventures, and a short commute to quaint Vermont towns.

We are eager to meet with you and share additional information about this enriching area of the health care we provide.

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