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Population Health Specialist

Population Health Specialist

CompanyAxessPointe Community Health Centers
LocationKent, OH, USA
Salary$Not Provided – $Not Provided
TypeFull-Time
DegreesBachelor’s, Associate’s
Experience LevelJunior, Mid Level

Requirements

  • Registered Nurse-ADN or BSN-Required
  • Holds and maintains BLS certification through the American Heart Association
  • Minimum 2 years’ experience in a clinical environment. Experience in an FQHC environment strongly preferred.
  • Knowledge MS Office, including Word, Excel, PowerPoint, and Outlook. Microsoft Access and Visio preferred.
  • Excellent organizational and interpersonal skills with exceptional professional work ethic.
  • Strong critical thinking and problem-solving skills.
  • Unrestricted license to practice nursing in the state of Ohio
  • Valid drivers license

Responsibilities

  • Assess and triage patient symptoms via phone using the nursing process and approved guidelines, to assist patient in obtaining the appropriate level of care and/or self-care advice maximizing office productivity.
  • Assist with comprehensive patient examinations, screenings, health education, and treatment of patients within the nurse’s scope of practice, using a systematic approach to history and physical appraisal of the patient, in person and over the phone.
  • Provides appropriate counseling and health education to patients, providing necessary literature and instructions for continuity of care, in person and over the phone.
  • Able to accurately prepare, administer/perform, and record medications and / or procedures directed by medical provider including nurse practitioner.
  • Develops and implements patient comprehensive management plans, records progress notes, and assists in provision of continuity of care.
  • Educates patients on disease and compliance with medical regimen, prescribed therapeutic and drug regimens, plan of care, self-care management, preventative health guidelines and the post-acute continuum of care.
  • Identifies & assists patient in accessing community resources. Evaluates effectiveness of developed plan of care; modifies and adjusts as appropriate to achieving desired process, utilization and clinical outcomes.
  • Reviews potential denials and refers all medical necessity denials to Medical Director or Physician designee for final determination.
  • Audit care management charts for completion
  • Implement and support protocols around clinical problems such as following up on referrals, management of abnormal tests and bringing patients up to date with preventative screenings.
  • Initiate, collect and execute population health outreach efforts.
  • Assist in the creation and delivery of presentations to various committees and boards about our programs.
  • Documenting and maintaining patient records of services provided according to prescribed program standards, documents all nursing care consistent with professional standards utilizing the agency approved EMR system.
  • Maintain a clean and orderly clinical atmosphere, performing routine monitoring and proper handling of equipment, medications, and supplies.
  • Serves as a clinical resource and go-to for Medical Assistant and other LPN staff, including staff training, education, and competencies as needed.
  • Maintains patient confidentiality at all times in accordance with HIPPA Regulations.
  • Follows Health Department guidelines regarding communicable diseases.
  • Other clinical duties and responsibilities as assigned by the Director of Clinical Services or Quality Coordinator.

Preferred Qualifications

  • Experience in an FQHC environment strongly preferred.