Ambulatory/Primary Care RN

Company: Partners Community Physicians Organization(PCPO)
Location: Somerville
Posted on: April 8, 2021

Job Description:

Remote-based position with occasional in-office presence required.Reporting to the Mass General Brigham Community Physicians Medical Director, the Registered Nurse will be responsible and accountable for planning and providing patient care for assigned patients in accordance with Nursing Standards of Care and organizational policies. The RN will collaborate and work closely with physicians, associate providers, clinical and administrative staff to enhance the delivery of patient care services along the continuum of care. The RN will perform phone triage for complex urgent calls, assist with triage for walk-ins, screen monitor and complete patient physical and emotional well-being assessments. The RN will also provide patient health counseling and instruction, including discussion with families and caregivers; will inform and educate patients regarding the meaning and implications of test results and interventions. The RN will perform post ED/Hospital/Post-Acute Follow up calls (TCM calls)The RN will assist with chronic disease, population health management and will ensure effective coordination of care across the continuum including working with Mass General Brigham, Brigham Health and community partners to include: home care, outpatient clinics, emergency/urgent care, and hospital settings. In addition, this individual will be responsible for assessing, planning, implementing, and evaluating a plan of care; initiating home care referrals and assisting with coordination of home care services.The RN will utilize a variety of modalities to engage patients including nurse visits, telephonic and electronic communication (Gateway) and will document all patient communications and clinical treatments accurately and appropriately in the electronic medical record, in compliance with nursing documentation standards.May be required in the office, to administer immunizations and injections; assist with treatments and procedures and assist the Care Team with patient flow, specimen collection, and intake when necessary and if MA unavailable.Qualifications Graduate of an approved school of nursing with current registration in MassachusettsAn Associate's Degree in Nursing or Bachelor of Science Degree in Nursing is requiredAt least 3 years of Ambulatory adult primary care LPN or RN experience preferredProficient in EMR (preferably Epic) for the facilitation of quality and timely patient Demonstrated ability to work independently with minimal supervision, as well as part of a cohesive teamExcellent critical thinking and communication skillsMaintain or obtain CPR certification and participate in site-based CPR drillsEEO Statement Equal Opportunity Employer

Keywords: Partners Community Physicians Organization(PCPO), Somerville , Ambulatory/Primary Care RN, Healthcare , Somerville, Massachusetts