Population Health Nurse

Job Description

QuadMed's dedicated health professionals focus on wellness and prevention, putting the patient at the center. Working as a team, we deliver high quality, integrated care while controlling ever-growing costs. QuadMed is an innovative leader in employer healthcare solutions, one of the fastest growing providers in the country. In partnership with our patients and the companies we serve, our mission is to create a culture of health.


GENERAL PURPOSE OF JOB
The Population Health Nurse will focus on supporting both the clinical care team and population health services team in improving health outcomes across the population we serve. This position will work closely with the QuadMed health and wellness center providers, medical assistants, and other QuadMed wellness services providers (i.e. CDE, RDN) on a daily basis. S/he will utilize population health management tools, clinical disease guidelines for outreach, identification of care gap analysis in creating work plans for the population health nurse and team to address population health outcomes. This role is responsible for enhancing clinical quality outcomes on an individual patient level, and assist patients throughout the continuum of care and at a population level.
KEY RESPONSIBILITIES
Assesses clients overall population for health improvement opportunities to analyze data for trends in health outcomes, gaps in clinical care, and high risk high cost patient conditions (such as hospitalization, ER/UC, prescription medication trends)
Researches best practices and methods along with clinical practice guidelines to improve processes that enhance clinic metrics and health outcomes
Collaborates with clinical quality to generate meaningful and accurate population health reports, assuring linkage to corporate and client objectives, and performance guarantees
Creates a strategic outreach program that is customized to their workforce, goals and budget; utilizes data (such as health assessment data, claim/utilization data, employee survey data, and biometric screening results) to provide outreach services
Collaborates with health and wellness center providers to identify high risk/target populations (i.e. high risk diabetics, noncompliant patients)
Creates a strategic outreach program that is customized to their workforce, goals and budget; utilizes data (such as health assessment data, claim/utilization data, employee survey data, and biometric screening results) to provide outreach services
Collaborates with health and wellness center providers to identify high risk/target populations (i.e. high risk diabetics, noncompliant patients)
Assesses, plans, directs and evaluates total nursing care as determined by the patients age-related physical, psychosocial, and cultural needs in accordance with established standards, policies and procedures of QuadMed and assigned client groups
Other duties
Acknowledges patients rights on confidentiality issues, maintains patient confidentiality at all times, and follows HIPAA guidelines and regulations
Completes all documentation accurately, timely and efficiently for regulatory compliance; demonstrates skills necessary for proper documentation in the Electronic Medical Record; participate in quality improvement, continuing education, and other patient care programs established by the health center requirements for QuadMed and/or assigned client groups
May perform occasional clinic nursing duties in the event of an employee illness or absence
JOB REQUIREMENTS
Appropriate education and/or experience may be substituted on an equivalent basis
Education:
Bachelors degree in nursing (BSN) from an accredited college or university
Experience:
Five (3) years of experience working in a clinical setting
A minimum of two (2) years of experience in care coordination, referral coordination, and/or population health management
Preferred experience:

A minimum of three (3) years of experience in clinical data analysis
(2) years Chronic Case Management experience preferred
Certificates, Licenses, Registrations:
Valid nursing license in the state of the position or compact state license required
Current BLS Certification; ACLS and/or PALS preferred
Knowledge, Skills & Abilities:
Familiarity working in an electronic medical records system, preferably working with population health management programs, such as disease registries
Must have strong nursing skills, with ability to work collaboratively with members of a clinical team
Exhibit excellent communication (verbally and written) and interpersonal skills, especially working with diverse populations; ability to have crucial conversations with patients one-on-one or in group settings, using a therapeutic and engaging approach to help change behaviors and lifestyles over time.
Ability to manage multiple tasks and organize time efficiently
In conjunction with clinic supervisor, delegate responsibilities to clinic staff (contact patient for follow-up, contact pharmacy to inquire about medication compliance, etc.)
Make recommendations to providers about care plan and promote additional services available to patients
Strong program-planning and marketing skills
ADDITIONAL COMPANY INFORMATION
We offer excellent benefits to eligible employees, including 401(k), holidays, vacations and more. In select states, patient care is provided by an independent physician-owned corporation.

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