Nurse Care Coordinator

Sweetser; Saco (ME); On-site; USD 69,000 - 75,000; Full time

Benefits offered by this job

Sign-on bonus

Job summary

Sweetser in Maine seeks a Nurse Care Coordinator to support regional primary and psychiatric care within Behavioral Health Home teams in Saco. This full-time role offers a $5,000 sign-on bonus and a rate of $33–$36 per hour, dependent on experience.

Responsibilities include medication education for the IDT, care planning, health screenings coordination, and ED utilization monitoring, with proficiency in EHR/HIN/VMS systems to support integrated care.

Qualifications

• Graduate from an accredited school of nursing.
• Current RN license in the State of Maine.
• Must be able to speak, read, and write English fluently.

Responsibilities

• Provide education and support around medications to the Interdisciplinary Team (IDT), members, and families.
• Provide medical education about chronic disease management to IDT members, families and groups.
• Liaison to Health Home, ACT Teams, CCBHC Practices/Primary Care Physicians.
• Collaborate with the IDT on member plan of care.
• Review Health Questionnaire and provide recommendations to IDT and/or members and families for medically compromised participants.
• Assist, and/or make recommendations regarding skill development in activities of daily living, including hygiene, nutrition, exercise, general health maintenance/improvement.
• Support implementation of grant funded projects such as In-Shape, CTI, and other health and wellness pay for performance initiatives in geographical area where program is offered.
• Support Behavioral Health Home team, CCBHC and Child ACT in achieving organizational and state required outcomes, including but not limited to A1C testing, tobacco screening and annual health screenings .
• Be proficient in EHR, HIN, and VMS systems in order to extract clinical data and alerts in order to support level of care.
• Consult with IDT and members as indicated regarding discharge planning recommendations and follow up.
• Monitor emergency department usage and coordinate with IDT and other providers to promote least restrictive level of care.
• Medication reconciliation through EHR from external providers (i.e. PCP, Specialists, etc.) when appropriate.
• Provide medication and medical education to Interdisciplinary Team (IDT), members, and families.
• Complete pharmacy enrollments, medical equipment orders, and other supports/services to support recovery goals.
• Provide CRMA Training and Supervision as needed.
• Schedules will vary according to program needs (as applicable): On-call responsibilities as assigned

Skills

Medication education

Interdisciplinary collaboration

Team coordination

Education

RN license in Maine

Graduate of accredited nursing school

Tools

EHR/HIN/VMS systems

Job description

Becoming part of the Sweetser family means you can make a difference in the lives of Maine children, adults, and families every day. As a nationally recognized and accredited leader, we offer competitive salaries, a wide range of benefits and the opportunity to join a passionate team of more than 700 employees.

Nurse Care Coordinator

Job Code: 13379

Location: Saco 04072

Department: Behavioral Health Home

FT/PT Status: Full Time

Summary:

The Nurse Care Coordinator shall provide regional primary care consultation, psychiatric care consultation; work with the Behavioral Health Home Organization (BHHO) & Certified Community Behavioral Health Clinic (CCBHC) team, Child Assertive Community Treatment Team, Private Non-Medical Institute, and other members to facilitate care across the healthcare continuum.

$5,000 sign-on Bonus!

Rate: $33 - $36 depending on experience

ESSENTIAL FUNCTIONS:

• Provide education and support around medications to the Interdisciplinary Team (IDT), members, and families.
• Provide medical education about chronic disease management to IDT members, families and groups.
• Liaison to Health Home, ACT Teams, CCBHC Practices/Primary Care Physicians.
• Collaborate with the IDT on member plan of care.
• Review Health Questionnaire and provide recommendations to IDT and/or members and families for medically compromised participants.
• Assist, and/or make recommendations regarding skill development in activities of daily living, including hygiene, nutrition, exercise, general health maintenance/improvement.
• Support implementation of grant funded projects such as In-Shape, CTI, and other health and wellness pay for performance initiatives in geographical area where program is offered.
• Support Behavioral Health Home team, CCBHC and Child ACT in achieving organizational and state required outcomes, including but not limited to A1C testing, tobacco screening and annual health screenings .
• Be proficient in EHR, HIN, and VMS systems in order to extract clinical data and alerts in order to support level of care.
• Consult with IDT and members as indicated regarding discharge planning recommendations and follow up.
• Monitor emergency department usage and coordinate with IDT and other providers to promote least restrictive level of care.
• Medication reconciliation through EHR from external providers (i.e. PCP, Specialists, etc.) when appropriate.
• Provide medication and medical education to Interdisciplinary Team (IDT), members, and families.
• Complete pharmacy enrollments, medical equipment orders, and other supports/services to support recovery goals.
• Provide CRMA Training and Supervision as needed.
• Schedules will vary according to program needs (as applicable):
• On-call responsibilities as assigned

GENERAL EXPECTATIONS:

• Provide excellent customer service
• Active participation in supervision of student interns, as appropriate and needed.
• Ensure the confidentiality of all patient information and release of information from area(s) of responsibility.
• Ability to support and recognize the important role volunteers play. Sweetser employees work with, support, collaborate with volunteers, and promote opportunities for volunteer engagement
• Exercise judgment consistent with clinically accepted standards of community practice in determining whether to transport a particular patient(s).
• Maintain adequate personal vehicle insurance coverage, a valid state driver’s license, a vehicle that is in good repair and a good driving record as per organization policy.
• Active participation in required supervision as determined with Program Manager according to licensure level.
• Timely and accurate provision of administrative paperwork according to the time frame established by the organization’s policies.
• Active participation in administrative meetings, including program meetings and general staff meetings.
• Understand and comply with all Sweetser policies and procedures as identified in the Human Resources Policy Manual.
• Maintain administrative responsibility (charting/documentation, etc.)
• Active participation in in-service training and continuing education programs.
• Active participation in providing community education to staff, community groups, etc., as appropriate and needed.
• Maintain minimum number of training hours mandated by professional licensure and required by state licensing.
• Maintain relationships with patients that promote dignity, equality and self-determination.
• Provide productive and supportive collaboration with peers/colleagues in the same program and across programs.
• Maintain productive and efficient relationships with all organization-wide personnel and programs.
• Maintain positive representation of the organization, at all times, with the public.
• Follow Suicide safer care practices.
• Other duties as assigned.

EDUCATION:

• Graduate from an accredited school of nursing.

CERTIFICATES, LICENSES, REGISTRATIONS:

• Current RN license in the State of Maine.
• Maintain a valid state driver’s license.
• Must be able to speak, read, and write English fluently.

EXPERIENCE:

• Previous experience working with adults with serious and persistent mental illness preferred.