Registered Nurse

Registered Nurse Overview

• The Registered Nurse role focuses on enhancing patient outcomes through clinic-based care and quality improvement initiatives.
• Collaborate with interdisciplinary teams to deliver evidence-based interventions and optimize patient care workflows.
• Support transitions of care, reducing avoidable emergency department utilization and readmissions.
• Engage patients and providers in proactive care opportunities to improve Medicare Advantage Stars ratings.
• Provide culturally appropriate chronic disease education to empower patients in self-management.
• Align daily responsibilities with organizational values of integrity, respect, and empathy.
• Contribute to health equity and patient-centered care through strategic outreach and education.
• Maintain compliance with regulatory standards and organizational policies.

Registered Nurse Key Responsibilities & Duties

• Analyze clinical data to identify gaps in care and prioritize impactful opportunities.
• Coordinate timely post-discharge follow-ups to prevent readmissions and address root causes of utilization.
• Conduct patient and provider outreach to close care opportunities and deliver tailored education.
• Perform medication reconciliation and ensure adherence to follow-up appointments post-discharge.
• Collaborate with interdisciplinary teams to implement evidence-based interventions and optimize workflows.
• Document outreach efforts and clinical interactions accurately in compliance with standards.
• Participate in quality improvement projects and provider education sessions.
• Support clinic operations through provider collaboration and community education initiatives.

Registered Nurse Job Requirements

• Bachelor of Science in Nursing (BSN) or Associate’s degree in nursing (ADN).
• Active, unrestricted RN license with 3+ years of clinical nursing experience.
• Proficiency in electronic health records and data analytics tools.
• Knowledge of Medicare Advantage Stars, HEDIS, and CMS quality requirements preferred.
• Experience with transitions of care and hospital discharge programs preferred.
• Bilingual proficiency in English and Spanish is advantageous.
• Basic Life Support certification required.
• Strong clinical judgment and ability to apply evidence-based practices.