Nurse Care Manager - Children & Youth Program

EOE Statement 

At HOPE, we are committed to fostering, cultivating, and preserving a culture of diversity, equity and inclusion.  Our goal is to be a diverse workforce that is representative, at all job levels, of the community we serve.  We embrace and encourage our employees’ differences in age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are proud to be an equal opportunity workplace and an affirmative action employer. 

SUMMARY  

Performs professional primary care nursing services in the assessment, evaluation, and management of care and medications for clients. Participates as part of treatment team in the development of client treatment plans by providing diagnostic and treatment recommendations. The Health Home Program Healthy Choices at HOPE focuses on providing integrated primary care and mental health/substance use services and support within the community.  The client will receive a supported team approach to care coordination in providing the client with support and resources needed to maintain outpatient recovery.  

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following, other duties may be assigned. 

Adheres to agency policy and procedures, CARF and DMHSAS standards and criteria, federal and state confidentiality rules and regulations including HIPAA and 42CFR part 2, and any special funding source requirements. 

Supports and promotes a service environment for individual in need of primary care, behavioral health and/or co-occurring services that is recovery focused, welcoming, and attentive to the needs of individuals who may have experienced trauma in their lives.  Attends annual core competencies training in relationship to individuals with co-occurring disorders or who have experienced trauma in their lives. 

Establishes and maintains professional working relationships with supervisor, peers and other staff.  Establishes rapport with clients, assessing client needs; organizes, plans and delivers face-to-face client services; and conducts follow up on the outcome of services provided. 

Scheduling and communicating appointment times, various appointments and follow up services including referrals into the community for specialty services or support services. 

Monitors eligibility status and coordinates referrals to the benefits specialist for eligible clients for Social Security, Title XIX or HMO (Medicaid), third party insurances and other benefits for which the client may qualify. 

Provides medical evaluations, crisis intervention, and pre-hospital screening for clients and non-clients.  Provides education and guidance to clients and families concerning proper usage and reactions associated with medications prescribed as well as diet, hygiene, and methods for prevention of chronic disease. 

Conducts initial appointments and initial health screenings.  Initiates and records information about client's medical history, documents current illness, pain, and/or health concerns, and coordinates with care management staff for follow up services.   

Performs screening for general health with priority for high-risk conditions and chronic illness.  Screening, monitoring, and interviewing for metabolic syndrome will be a priority.  Services will focus on reducing care gaps for receiving quality screenings and care services.   

Identification of major chronic illnesses including but not limited to diabetes, BMI, blood pressure, and cholesterol.  Preventable and modifiable risk factors will be offered to address chronic wellness including care gaps that may occur for access and/or resources and referrals.   

Coordinates and participates in Healthy Choices at HOPE treatment team and comprehensive care planning for recovery services.   

Coordinates services with external and community providers, as well as monitoring data information input into the clients’ health record using Health Information Technology Systems.  Develops registries for consumer identification in Health Home services. 

Reviews assessments and coordinates primary care and specialty care referrals with the care coordinator or case manager providing the primary behavioral health services. 

Advocates for consumers and community members in need of primary care and/or behavioral health services. 

Analyzes reports and findings of tests and of examination and determines appropriate diagnosis. 

Orders or initiates various tests, analysis, and diagnostic images to provide information on client's condition. 

Provides medication clinic services to clients and staff of the agency and educates consumers about their medications, side effects, and problems associated with mixing medications and alcohol.   

Provides clinical consultation to ensure appropriate diagnosis and course of treatment. May be required to provide consultation services outside scheduled work hours. 

Utilizes the philosophy of Collaborative/Therapeutic Documentation to meet clinical record keeping documentation standards and ensure documentation is completed with the Consumer to the extent possible and all documentation is completed on the same day of the date of service.  Reports and documents services in accordance with agency policy and procedures. 

Interacts with other professionals to discuss health and wellness or treatment, new resources or techniques, and to share information. 

Provides back up coverage to the URC in accordance with the established chain of coverage. 

Reports and documents services in accordance with agency policy and procedures. 

May be required to work evening or weekend hours. 

Performs other related duties as assigned. 

QUALIFICATIONS 

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

EDUCATION and/or EXPERIENCE  

Oklahoma licensed LPN or RN with experience in community based mental health. 

CERTIFICATES, LICENSES, REGISTRATIONS  

Licensed LPN or RN. In Oklahoma 

Required to complete Therapeutic Options, or approved safety training and annual updates. 

May be required to obtain and maintain First Aid and CPR Certifications. 

May be required to complete and maintain Wellness Coach Certification 

LANGUAGE SKILLS  

Ability to read and comprehend instructions, detailed correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to families, clients, and other employees of the organization. 

REASONING ABILITY  

Ability to apply commonsense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.  Ability to seek out supervisory assistance for additional training when needed and make application of techniques or other skills to meet essential job duties and responsibilities. 

OTHER SKILLS AND ABILITIES  

Ability to relate to persons with severe mental illness in a positive, helpful and welcoming manner.  Ability to establish and maintain effective and tactful working relationships with co-workers; to express ideas and facts clearly and concisely in written or oral form. 

PHYSICAL DEMANDS 

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

While performing the duties of this job, the employee is regularly required to sit. The employee frequently is required to reach with hands and arms; and talk or hear. The employee must occasionally lift and/or move up to 5 pounds. Employees must have vision enough to read written or typed data; hearing and speech enough to communicate effectively with staff, clients, and public in person or by phone and to dictate service notes for transcription. 

WORK ENVIRONMENT 

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

The noise level in the work environment is usually quiet.