Registered Nurse - Cardiac Outpatient Resource (COR)

Sutter VNA & Hospice, one of the largest, not-for-profit home health and hospice agencies in Northern California enables patients to recover or live with illness in the comfort and dignity of their own homes, surrounded by the people and things they love. Sutter VNA & Hospice also provides service in the complementary areas of Sutter Home Infusion and Pharmacy (SIPS) and Home Medical Equipment (Timberlake). Providing a full spectrum of home based health services enables us to coordinate care across the Sutter Health and community networks. Sutter VNA & Hospice is proudly not-for-profit. Unlike for-profit home care and hospice agencies, we do not report to shareholders. Instead, all of our revenue is used to provide patient care and to support our policy to provide care regardless of a patient's financial circumstances.Sutter VNA & Hospice is committed to being the “employer of choice” through competitive wages and benefits, flexible schedules, new technologies including laptop computerized charting, tuition reimbursement, and more!Come join our new Heart Failure Continuum at Sutter VNA & Hospice.  We are developing a new model of care that bridges inpatient and outpatient settings. Under the supervision of the Heart Failure (HF) Program Manager, the Cardiac Outpatient Resources (COR) RN is an experienced RN who is responsible for the overall management of COR patients including telemanagement and specialty home visits. This position plans, organizes, and directs all patient care services for patients in the assigned caseload in accordance with current protocols and standards, ensuring that the optimal degree of quality care is maintained.  Responsible for coordinating care to implement the established plan of patient care and ensure effective management of phone and home visit utilization and control of expenses.  Responsible for coordinating certain operations of the HF Program, including collaboration of services with the patient, physicians, nursing staff, case managers, social workers, home health, hospice, hospitals and other ancillary services. May assist in agency wide orientation, competency evaluations and consultation to clinical staff related to specific expertise as requested by HF Program Manager. This position includes communication with various departments and disciplines, telephone monitoring/surveillance, patient assessment and education, and research.  The COR RN works to support the patient in a professional manner consistent with existing and developing policies. Provides optimal outcomes through collaboration with the client, the family, caregivers, physician and other members of the healthcare team.Education:RN graduate from an accredited institution. Bachelor’s degree in nursing preferred, MSN optional. Licensure:Current California RN; valid California driver’s license; current auto insurance; current BCLS/CPR certification. Experience:Telemanagement or telemonitoring experience strongly preferred. Heart Failure or Cardiovascular experience strongly preferred.  One year of professional experience in an acute or similar setting preferred.  Home Health experience helpful.Knowledge:Strong Cardiovascular and/or Heart Failure knowledge including current evidence-based treatment for cardiac disease states.  Knowledge of chronic disease management, and educating and coaching patients to self manage their disease process.  Knowledge of health care and community resources appropriate for populations served.  Knowledge of individual and family development over the life span and the influence of cultural and spiritual values in health care.  Knowledge of adult education and teaching principles. Demonstrated computer proficiency with databases and Microsoft suite applications is required.Special Skills/Equipment:Self-starter with a high degree of initiative, motivation, flexibility, energy and creativity.  Must have the abilities to work independently with a minimum of direction, anticipate and organize workflow, prioritize, plan and problem solve and follow through with patients and others.  Strong attention to detail and accuracy is required. Must have excellent oral and written communication, organizational skills, interpersonal, problem-solving, time management, and positive personal influence and negotiation skills.  Must have strong clinical assessment, physical, psychosocial, and environmental, and critical thinking skills necessary to provide care-planning, treatment initiation and follow-up based on algorithms appropriate to patients with complex medical, emotional, and social needs.  Ability to motivate, mentor, coach, and redirect patients in order to achieve compliance with medical, social, and functional interventions. Ability to form harmonious working relationships with internal and external customers.  Must have the ability to work in a high volume caseload environment and deal effectively with rapidly changing priorities.  Ability to work respectfully and creatively with clients of diverse functional abilities, social, economic, and cultural backgrounds to support both client autonomy and client safety.  Demonstrated leadership and negotiation skills and the ability to manage resources for patient care in a cost effective manner.  Excellent collaborative and problem solving skills with patients, families, caregivers, and other health care providers.  Leadership skills to delegate and provide direction or guidance to staff and hold others accountable.  Must be effective both as a team member and leader.  With appropriate training, demonstrates an ability to competently work with the computerized documentation tools and systems of the organization.