Clinic Nurse

Madison Valley Medical Center (MVMC) is an equal opportunity employer. MVMC shall, upon request, provide reasonable accommodations to otherwise qualified individuals with disabilities.

This job description is intended to reflect core areas of responsibility and an incumbent employees’ knowledge and skill set needed to complete those functions. This document is not intended to catalog each individual duty; employees are routinely called upon to address emerging employer requirements in alignment with individual work units and assignments of jobs. The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer change.

Job Title: Clinic Triage/Nurse

FLSA Status: Non-Exempt

Department: Clinic

Reports to: Clinic Manager

POSITION PURPOSE (Summary)

The Clinic Triage/Nurse reports to the Clinic Manager and is responsible for answering patient inquiries over the telephone, assessing the severity of the patient's symptoms and medical needs. Guides the patient to the appropriate level of care; schedules patient appointments over the phone with appropriate healthcare providers/facilities/physicians. Documents information provided to patients during triage in health record systems, records patients health conditions for follow-up patient care. Maintains and develops triage protocols; ensures patients' healthcare information is updated on time. Performs all duties in a manner consistent with the mission and values of MVMC.

GENERAL RESPONSIBILITIES

• Triage Phone Response: Manages patient health concerns and symptoms via a telephone interaction utilizing protocols for the assessment and management of a range of symptoms. These telephone interactions require assessment, patient education and may require crisis intervention. Responds to and prioritizes incoming patient messages and test results. Schedules appointments as needed. May schedule tests and procedures and facilitate insurance prior-authorization. Review and authorize/deny provider ordered prescriptions in accordance with established guidelines when needed. Delivers patient education, according to the individualized needs of the patient and as prescribed by the Provider and/or Group policy. Educates patient and/or family members about diagnostic procedures, medications, nutrition and maintenance of health and wellness. Responds to patient questions and appropriately provides reassurance while responding to patient concerns.
• Patient Documentation: Maintains accurate and detailed patient records and pertinent information; posts tests and documents patient education provided.
• Enter all pertinent communications with the patient into the Medical Record.
• Enter clinical RN note in patients’ chart with details of Triage call.
• Notifies ED RN of potential patients and gives report on their current condition based on the triage call. Including but not limited to, patients reported symptoms, RNs recommendation of action for patient, patients’ response to RNs recommendation, approximate arrival time to the ED if indicated and the report given to the ED personnel.
• Clinical Resource for Staff: Performs and delegates a variety of tasks to facilitate patient care. Aware of coding and reimbursement issues. Available to other offices, clinical and non-clinical staff to answer questions and provide assistance as appropriate. Assists in orienting and training new staff. Seeks opportunities to improve or enhance nursing and leadership skills.
• Other Duties as Assigned: Utilizes current nursing practices to provide patient care while focusing on the needs of the patient and exemplifying service excellence, care, concern, respect and cooperation. As a member of a health care team, functions in the role of patient advocate by being in the position of initial contact for patient-related issues.
• Other duties as assigned.

COVID-19-Roles and Responsibilities

• Be knowledgeable in COVID-19 facts and become familiar with the CDC guidelines and current recommendations regarding COVID-19.
• Assess a patient's current situation, illness, and/or risk factors related to COVID-19
• Work collaboratively with Madison County Public Health Department and Ennis School District (school nurse) in managing COVID-19
• Attend all COVID-19 related meetings in house or via ring central (TEAMS) and provide daily COVID-19 Nurse Updates.
• Answer questions and council staff, community members, patients, and patients' family members within the nursing scope of practice and seek council from the on-call provider and appropriate resources when needed.
• Enters all pertinent communications with the patient into the Medical Record

Chronic Care Management

Care Plan Development & Management

• Develop and maintain individualized comprehensive care plans for patients enrolled in the CCM program.
• Review the patient's chronic conditions, medications, treatment goals, healthcare needs, and identified barriers to care.
• Update care plans when there are significant changes in the patient's condition, treatment, medications, goals, or healthcare needs.
• Ensure care plans are accessible to appropriate members of the patient's healthcare team.
• Provide patients and/or caregivers with appropriate education regarding chronic conditions and care goals.

Monthly Patient Check-Ins

• Complete monthly outreach and check-ins with enrolled CCM patients and/or their caregivers.
• Assess the patient's current health status, symptoms, medication concerns, appointments, and progress toward established care plan goals.
• Identify new concerns or changes in condition and communicate these to the appropriate provider.
• Assist patients with questions regarding their treatment plan and help identify barriers to following provider recommendations.
• Document all CCM activities and patient/caregiver communications accurately and timely.

Care Coordination

• Collaborate with primary care providers and other members of the patient's care team to promote coordinated, patient-centered care.
• Communicate with specialists, hospitals, pharmacies, home health agencies, therapy services, community resources, and other healthcare organizations as appropriate.
• Assist with coordination following hospitalizations, emergency department visits, specialist appointments, or significant changes in the patient's condition.
• Help ensure providers are aware of important changes in the patient's health, medications, treatment recommendations, or care needs.
• Facilitate communication between the patient, caregiver, primary care provider, and other members of the care team.

Documentation & CCM Time Tracking

• Maintain accurate documentation of all CCM services provided.
• Track qualifying CCM time and activities according to current program and payer requirements.
• Ensure documentation supports the services and charges submitted.
• Review monthly CCM activity to determine whether applicable time and service requirements have been met.

Charge Entry & Billing Support

• Enter/drop appropriate CCM charges based on documented services and qualifying time.
• Verify that documentation supports the charge being entered before submission.
• Participate in periodic review of CCM documentation and billing processes to promote compliance.

Medication Refills

• Refill routine prescriptions based on patient and pharmacy requests via fax or phone.
• Complete Prior authorizations for medications as needed.
• Send refill requests to providers for approval on all controlled substance prescriptions.
• Manage and organize controlled prescription patient list including their Controlled substance contract date, last follow up appointment and last annual exam and UDA.
• Communicate with patients the requirements for 1 annual exam per year plus regular follow up appointments as required by their PCP as well as 1 random UDA a year.
• Schedule patients for appointments as needed and assure that they stay current on their visits per their written contract.
• Call patients and inform them of their selected day for a random UDA as indicated by the Controlled Substance tool, verified by their PCP.
• Schedule continued Substance Contract meetings with providers, clinic manager, pharmacy and lab as the need arises based on failed UDAs and with other patient issues on a case-by-case basis.

Requirements

MINIMUM REQUIREMENTS (Education, License/Registration, Experience, Knowledge and Abilities)· Montana RN License or bachelor’s degree in nursing required.· One year working as a school or community health nurse preferred.· Two years’ experience Medical/Surgical preferred.· One year experience ER preferred.· A minimum of one year of professional nursing experience in a clinical or hospital setting preferred.· BLS & CPR (required upon hire). · Annual Safety Training and annual N-95 Mask Fitting.· Basic working knowledge of PC skills required. Non-Essential Functions: Attend workshops, seminars, and educational sessions to keep updated on changes in assigned area(s) of responsibility. Knowledge and Abilities · Interpersonal Skills: Conveys a warm, caring, and approachable demeanor. Displays unconditional respect toward others. Able to sense other feelings and perspectives.· Service Orientation: Ability to anticipate, recognize, and meet the needs of patients and their families.· Oral Communication: Listens openly and clearly conveys messages and information.· Written Communication and Comprehension: Writes dearly using appropriate grammar, symbols, and medical terminology. Able to decipher and comprehend documentation of others.· Teamwork: Works effectively with others to accomplish objectives and goals. Offers assistance to others in need.· Multi-tasking: Able to properly perform multiple duties at once.· Resilience: Effectively manages stress in a fast-paced setting.· Leadership: Appropriately optimistic and inspiring. Influencing others to act on their own behalf or for the broader good of the group.· Age and Cultural Specific Care:

• Able to adjust treatment, instruction, and education to meet the patient's age and cultural background.
• Excellent organizational skills and attention to detail.· Strong analytical and problem-solving skills.· Strong supervisory and leadership skills. Non-Essential Functions: Attend workshops, seminars, and educational sessions to keep updated on changes in assigned area(s) of responsibility.

PHYSICAL DEMANDS AND WORKING CONDITIONS The demands and conditions described here are representative of those the employee must meet to perform the essential functions of the job (see special accommodation statement).Extensive standing and walking with occasional reaching stooping, kneeling, and crouching. Must be able to lift, carry, push, or pull at least 50 pounds. Very good close vision and the ability to identify and distinguish color. Prolonged periods of sitting at a desk and working on a computer. Work is in a clean office environment. Noise level is quiet to moderate. Frequent keyboarding and repetitive movements. Supervision Exercised: This position does not supervise other staff.