Come join the largest public hospital system in the nation! Every day, we work together to make an extraordinary difference in the health and well-being of each individual we serve - without exception.
NYC Health + Hospitals is an integrated health care system of hospitals, neighborhood health centers, long-term care, nursing homes, and home care – the public safety net health care system of New York City. NYC Health + Hospitals is committed to the health and well-being of all New Yorkers and we offer a wide range of high quality and affordable health care services to keep our patients healthy and to address the needs of New York City's diverse populations.
NYC Health + Hospitals is currently seeking several Chronic Disease Nurses who will have dual reporting structure. The RN Chronic Disease Coordinator will report to Facility ambulatory CNO. Duties will include:
-Work at one of our adult primary care clinics to improve the quality of chronic disease care.
-Focus 50% on direct patient care and 50% on performance improvement responsibilities.
-Provide direct clinical care, for patients with uncontrolled chronic conditions e.g., hypertension or diabetes. This can include
-Educate patients about diagnosis, treatment, medications, and needed follow-up
-Conduct nurse follow-up visits for HTN management, insulin teaching and/or titration.
-Identify underlying challenges such as socioeconomic, cultural, physical or language barriers
-Collaborate with patients, families and care team to address barriers, using strategies such as motivational interviewing and brief action planning.
-Liaise with social work department to develop strategies to address social determinants (e.g., homelessness or food insecurity)
-Organize group medical visits and moderate discussion to optimize peer-peer support
-Collaborate with central office staff in the Office of Population Health to implement chronic disease performance improvement initiatives.
-Report progress bi-weekly on facility chronic disease initiatives
-Coordinate and collaborate with facility clinical, nursing and administrative leadership to drive continuous performance improvement for chronic disease management
-Educate ambulatory nursing staff on chronic disease initiatives
-Monitor adherence of ambulatory nursing staff to performance improvement plans
-Track and share quality metrics with stakeholders across the facility
-Implement OPH disease management toolkits to drive facility change.
-Coordinate with OPH and facility leadership to address barriers in achieving improvement goals.
- Valid NYS RN license
- Bachelor’s degree in Nursing
- Minimum 3 years of experience working in a health care setting
- Mission driven and a motivated self-starter with initiative
- Well organized and able to prioritize competing demands from multiple sources in a deadline-driven environment.
-Strong team player with excellent communication skills.
New York, New York , 10041
NYC Health + Hospitals
Oct 3rd, 2018