- Work collaboratively with a multidisciplinary care team across the continuum of care for high-risk patients
- Provide care and disease management coordination
- Identify patients in the specialty care practice that have ongoing coordination needs and conduct targeted outreach
- Conduct comprehensive clinical assessments that include disease/age-specific, medical, behavioral, pharmacy, social, and end of life needs of each patient
- Inform and work with patients and their families regarding coordination of their care, provide education and coaching, monitor patient compliance with their care plan, perform reassessments regarding patient progress toward goals, and update plan of care
- Serve as a liaison and advocate for patients and families
- Assist in managing transitions of care across care settings, ensuring optimal communication and planning
- Identify barriers, facilitate solutions, and connect others to community resources
Requirements
- Graduate from an accredited school of Professional Nursing
- Current state licensure as a Registered Nurse (RN)
- Basic Life Support (BLS) Certification through the American Heart Association (AHA) or American Red Cross
- Three to five years of nursing experience
- Any registered nurse or advanced practice nurse must obtain a cancer specific certification or demonstrate ongoing qualifying education within the timeframe of the facilities accreditation cycle if they work in medical oncology, radiation oncology, cancer center, or cancer clinic and/or administer chemotherapy within an accredited Cleveland Clinic facility
Core Competencies
Demonstrates expertise in patient care coordination, clinical assessment, and disease management for high-risk patients, while effectively communicating and collaborating with multidisciplinary care teams. Holds relevant nursing certifications and licenses to ensure compliance with healthcare standards.
Highest-signal resume keywords
- Registered Nurse (RN) License
- Basic Life Support (BLS) Certification
- Patient Care Coordination
- Clinical Assessment
- Cancer Specific Certification
ATS Optimization Keywords
Hard Skills
- Clinical Assessment
- Disease Management Coordination
- Patient Compliance Monitoring
- Care Plan Reassessment
- Outreach Coordination
Soft Skills
- Collaboration
- Advocacy
- Communication
- Problem-Solving
- Education and Coaching
Certifications & Qualifications
- Registered Nurse (RN) License
- Basic Life Support (BLS) Certification
- Cancer Specific Certification
Industry Keywords
- Multidisciplinary Care Team
- High-Risk Patients
- Transitions of Care
- Community Resources
- Oncology Care