Looking for a Registered Nurse, RN to coordinate and provide high quality multidisciplinary health services for patients in the assigned region consistent with Agency philosophy, policy, goals and objectives, and Standards of Nursing Practice. Works under moderate supervision.

• Assesses the physical, social and psychological needs and living conditions of the patient through professional knowledge and skills of observation, interviewing and physical examination.
• Travels to patients’ homes and/or other facilities with varying environments (e.g., elevated buildings, walk-ups, care facilities, single/multiple family homes, presence of pets, etc.) using approved transportation options to deliver direct care to the patient.
• Acts as the coordinator of care for the multidisciplinary team by providing care to patients collaborating/making/confirming referrals to other disciplines /community agencies and ordering supplies/services and ensuring they are delivered as needed.Consults patient’s MD and follows-up on problematic situations affecting care such as abnormal clinical findings or medication discrepancies.
• Establishes/implements/revises a plan of care with input from appropriate multidisciplinary health team members (i.e., physician, OT, PT, SW, SLP, family members) based on goals mutually acceptable to the patient and significant others. Implements the care plan by ongoing assessment, planning, coordination, counseling, teaching and supervision.
• Oversees/supervises the care being provided to the patient by Licensed Practical Nurses and paraprofessionals through regular home visits (every two weeks or sooner), which are in compliance with regulatory requirements. Assesses the patient’s condition and updates the plan of treatment, as needed.
• Provides nursing care in accordance with Agency policies, practices, procedures and Standards of Nursing Practice, which may require standing, stooping, sitting, crouching, bending and stretching to deliver patient care.
• Performs other related duties and participates in special project, as assigned.

Licensure:  License and current registration to practice as a registered professional nurse in New York State required.  Valid driver's license or NYS Non-Driver photo ID card, may be required as determined by operational/regional needs.

Education:  Degree in Nursing from an approved program required.

Experience for CHHA:  Minimum of one year of experience in a medical/surgical environment preferred.  Bilingual skills may be required, as determined by operational needs.

CS2019