About CityLife: CityLife Neighborhood Clinics… Improving health block by block… It’s a movement!  CityLife is changing how members should think of primary care. Like the old family doctor, primary care is the first place to go for all your health needs. A primary care physician has been the first stop to diagnose & treat illness. Now, primary care is still where you go when you are sick & want to feel better, but also when you need help with the health care system & when you are well & want to get healthier.

Only you can improve your health, but you do not have to do it alone.  At CityLife, we know health is more than just physical, which is why we have a care team in place to take care of the whole you, as a person, and not as a condition! The minute you walk in the door, a warm family feel not only makes you feel cared for, but comfortable.  At CityLife, you not only have a doctor, but a whole team of health care professionals built around you and your needs!  The health care system is hard to navigate, and at CityLife, we know that. That is why we have made it our mission to make health easier by offering same-day visits, walk-in care and so much more!

Position Description: Reporting directly to the Clinical Services Leader, the Care Team Nurse - RN is responsible for the day to-day delivery of appropriate, timely and beneficial care for members, promoting quality healthcare and outcomes. The RN works in an inter-disciplinary care team environment, alongside the Provider, LPN, Pharmacist, Behavioral Health Specialist, and Administrative Assistant.

Essential Duties:

• Coordinates multi-disciplinary member care conferences for high risk or complex members as needed.
• Manages panel acute care and chronic care needs as well as health maintenance, meeting or exceeding clinic expectations for health maintenance standards.
• Utilizes client based tracking system or clinical databases to track, monitor and assure the appropriate follow-up of clients.
• Handles referrals in conjunction with partner; provides providers; schedules diagnostic studies; clinic appointments.
• Participates in the continued development of the role-of-case management in the Primary Care-Advance Access model
• Makes meaningful improvement to services, program, and processes and/or organizational effectiveness that create new value for members and employees.
• Develops, implements, and evaluates care plans.
• Provides member education, advice and information on health assessment, disease processes, medications and treatment plans.
• Works collaboratively across disciplines and administrative functions across the organization and in the community.
• All other duties as assigned.
•  

Qualifications/Skills:

• Bachelor’s or Associate's Degree in Nursing. Current registered nurse license in state of Pennsylvania.
• Minimum of one (1) year experience in nursing.
• Knowledge of applicable laws such as client confidentiality, Americans with Disabilities Act, Workers’ Compensation, abuse reporting, principles of consent, and advanced medical directives.
• Excellent interpersonal and communication skills required to effective handle team members, patients, and family members.
• Ability to perform job using theory-based nursing practice model, evidenced based practices, and shared governance in a multidisciplinary team model.
• Knowledge of scope of member care services provided by other clinical service lines and the referral process.
• Knowledge of general medical procedures and the ability to anticipate complications and the indicated therapeutic interventions.
• Knowledge of clinic practices and ability to act as a resource for clinic personnel and assist the Providers as necessary.
• Ability to receive information, concerns and feedback in a supportive manner.
• Ability to assess external factors that impact health and behavior.