Registered Nurse

nLeague; Cookeville (TN); On-site; USD 60,000 - 75,000; Full time

Job summary

A healthcare organization is seeking a Registered Nurse 1 located in Cookeville, Tennessee. The role involves collaborating with primary care providers to assist patients in navigating social determinants of health, providing screening assessments, and coordinating care. Candidates must possess a Registered Nurse License and demonstrate strong communication skills. This position involves both in-person and remote patient interactions to ensure comprehensive support and education in accessing necessary resources.

Qualifications

• Must be a licensed Registered Nurse with experience in social support.
• Ability to coordinate care among various services and sectors.
• Strong communication skills to interact with patients and providers.

Responsibilities

• Take referrals from primary care providers.
• Provide in-person or remote social needs screening.
• Coordinate social services resources.
• Conduct case management activities.
• Assist patients with accessing medical equipment.

Skills

Social support navigation

Case management

Collaboration with healthcare providers

Patient education

Education

Registered Nurse License

Tools

Personal Computer

Telephone

Job description

Job ID: 65532

Position: Registered Nurse 1

Location: 1100 England Drive, Cookeville, Tennessee 38501

Client: TN DOH

Duration: 14 Months (Possibility of extension)

Responsibilities

The Clinical Care Team will take referrals from primary care providers and will work with the primary care team to accomplish the following tasks:

• Social support navigation for social determinants of health (SDOH) such as food insecurity, housing insecurity, etc.
• Compile and maintain a resource list for SDOH resources including eligibility criteria, referral process, and contact information
• Collaborate with primary care nurse and providers
• Provide in-person or remote social needs screening/assessment with primary care patients referred by nurse or provider
• Coordinate or make aware of social services resources, i.e., housing, clothing, food, mental health services, etc.
• Collaborate with other social workers to identify patient and community resources
• Conduct case management activities
• Work with hospitals for discharge planning, follow-up and education
• Assist with obtaining patient records from hospitals
• Assist in securing needed medical equipment through community partners
• Conduct follow-up on care plans
• Identify patients lost to follow-up or overdue for care and assist them in returning to care
• May assist with specialty referral navigation
• Schedule, coordinate, and track non-BCS specialist and imaging referrals
• Assist with obtaining patient records from specialists and imaging centers
• Compile and maintain resource list for specialty referrals including eligibility criteria, referral process, cost and contact information
• Assist patients to locate and access low-cost prescription options such as patient assistance programs, discount retailers, etc.
• May assist with patient assistance program applications and serve as a patient-provider liaison with the drug companies
• Assist patient with applications for programs such as CoverRx and RxOutreach
• May help with other regional primary care-based initiatives with a social work component
• Documents in patient’s record, updates consults, and tags provider and/or clinical staff as necessary
• Provide patient education or find appropriate education resources

Expectations

• Complete onboarding and orientation
• Participate in regional office and primary care clinical meetings as requested
• Attend provider meetings as requested
• Attend Health Councils and other community meetings to build relationships with social service agencies and promote health department services
• Identify barriers to care or assistance experienced by our patients and seek ways to address them

Tools & Equipment

• Personal Computer
• Telephone
• Fax Machine
• Printer
• Scanner
• Copy Machine
• Calculator