Registered Nurse - Nurse Care Manager - Ames

Primary Health Care, Inc (PHC); Ames (IA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Generous PTO accrual

License/certification fee reimburse

Continuing education reimbursement

401k with company match

Medical insurance

Vision insurance

Life & disability insurance

Flexible spending & health savings

Supplemental accident & critical Ill

Discounted pet insurance

Mileage reimbursement

Job summary

Primary Health Care, Inc (PHC) in Ames, IA is seeking a Nurse Care Manager to join our Story County Clinic team. This role focuses on risk stratification, guidance for chronic conditions, and psychosocial support for patients with complex needs.

Typical schedule is Monday–Friday 8 AM–5 PM, with occasional travel to other PHC sites. You will work within an interdisciplinary team, document care in the electronic health record, and participate in population health initiatives and care coordination

Qualifications

• Completion of an accredited nursing program accepted by the Iowa Board of Nursing for licensure.
• Strong verbal and written communication skills with education delivery ability.
• Interpersonal skills to maintain professional relationships across diverse groups.
• Ability to collaborate and work autonomously.
• Commitment to service excellence and initiative.
• Time management to balance tasks and schedules.
• Proficiency using electronic health records and Microsoft Office.
• Adheres to patient confidentiality standards.
• Current RN license recognized by the State of Iowa and BLS.
• Must obtain required licensure within Introductory Period if not current.

Responsibilities

• Implements risk stratification to identify patients needing higher-level care management.
• Provides holistic care management and coordination for complex patients.
• Participates in interdisciplinary care team and PHC iCare values.
• Utilizes RN-led Visit Model and conducts nursing assessments, planning, and evaluation.
• Supports pre-visit planning, post-visit follow-up, and care coordination.
• Documents care accurately in the electronic health record.
• Performs nursing triage and refers or monitors as needed.
• Assists with panel assignments and staffing balance within care teams.
• Engages in population health management and data monitoring.
• Travel to other PHC sites for meetings as needed.

Skills

RN license Iowa

BLS for Healthcare Providers

Mandatory Reporter Training

Interpersonal skills

Verbal and written communication

Autonomous collaboration

Time management

Confidentiality

EHR proficiency

Microsoft Office proficiency

Education

RN license Iowa (active)

BLS for Healthcare Providers

Mandatory Reporter Training (Iowa)

Tools

EHR software

Microsoft Office

Job description

As a Nurse Care Manager at PHC, you will implement risk stratification strategies to identify patient populations requiring higher-level care management, disease/chronic condition management, and psychosocial support, and you will provide holistic care management and coordination for those patients with complex needs. You will work as part of our interdisciplinary care team to meet the changing needs of our patients. All team members must demonstrate PHC iCare values in daily work.

This position typically works at PHC Story County Clinic in Ames and is scheduled Monday - Friday 8 AM - 5 PM. This position occassionaly travels to other sites for meetings.

Our team members are occasionally needed to cover other shifts or to work at other PHC clinics in Ames, Des Moines, and Marshalltown. Mileage reimbursement and/or an out of town travel bonus may apply.

What You Will Do

Utilizes Interventions for Population Health Management to maximize the health and recall opportunities for patients who are care-managed, part of the Accountable Care Organization contracts, or warm hand-offs from PHC providers with complex needs. Addresses the medical, psychosocial, health risk, prevention, wellness, and education needs of the patient and/or family.

Utilizes the RN-led Visit Model, including nursing assessment, diagnosis, planning, implementing, and evaluation of nursing care plans. Provides care management, care coordination, chronic disease and preventive screening and education for patients and/or families.

Supports PHC Way initiatives and actively assists in pre-visit planning, post-visit follow-up, and care coordination. Executes the strategy for planned visits, including appropriate health prevention and screening activities.

Participates in Accountable Care Organization activities such as value-based care and shared savings initiatives, completes Medicare Annual Wellness Visits and Medicaid recall care coordination, andprovideschronic care, disease management, and complex care management.

Documents patient care accurately and timely in the electronic health record.

Assists with panel assignments and workload, support teams to balance the complexity and continuity of care needs of patients and the care teams.

Performs nursing triage of acute medical issues for clinic patients as needed, refers or monitors appropriately.

Utilizes data systems and reporting to monitor population health management patient outcomes and identify gaps in care.

Participates in grant-related clinical initiatives.

Qualifications You Need

Required

• Completion of an accredited nursing program accepted by the Iowa Board of Nursing for licensure.
• Verbal and written communication skills, including the ability to provide effective education to others.
• Interpersonal skills and the ability to maintain professional relationships with a wide variety of people.
• Ability to work collaboratively and autonomously.
• Commitment to service excellence.
• Self-motivated and takes initiative.
• Active listening skills and a willingness to take direction.
• Problem-solving skills with the ability to apply critical thinking and assessment within a nursing framework.
• Time management skills with the ability to efficiently move between tasks.
• Consistently meets the department work schedule as assigned.
• Detail oriented.
• Proficiency using electronic health records, Microsoft Office applications and internet-based applications.
• Adheres to patient confidentiality standards.
• Ability to consistently meet care manager measures and acceptable performance standards.
• Licenses & Certifications:Current RN license recognized by the State of Iowa; *Current Basic Life Support (BLS) for Healthcare Providers; *Current Mandatory Reporter Training: Child Abuse and Dependent Adult Abuse recognized by the State of Iowa
• * Must be obtained within the Introductory Period if not current.

Preferred

• Bachelor of Science in Nursing.
• Experience in a community health center or public health organization.
• Experience with population health, care management/coordination, the Chronic Care Model, health registry systems, or community resources.
• Spanish language skills, written and verbal.

We Take Care of Our People

In addition to base pay, PHC offers a comprehensive benefits package, including:

• Generous PTO accrual
• License/certification fee reimbursement*
• Paid time off for continuing education & continuing education reimbursement*
• 401k with company match
• Medical insurance
• Vision insurance
• Life & disability insurance
• Flexible spending & health savings accounts
• Supplemental accident & critical illness insurance
• Discounted pet insurance

Visithttps://phciowa.org/careersfor a summary of PHC’s benefits.

*Applies to positions requiring clinical licensure or certification.

Grow Your Career with PHC

We take pride in offering development and growth opportunities to our team. Some of our training opportunities include Emerging Leaders, Dental Assitant Trainee Program, & Medical Assistant Trainee Program. In the last year, over 30% of our open positions were filled through promotions or transfers.

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