Nurse Care Manager, Senior Care Team

Who We Are:

Since 1985, BHCHP’s mission has been to ensure unconditionally equitable and dignified access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. Over 10,000 homeless individuals are cared for by Boston Health Care for the Homeless Program each year. We are committed to ensuring that every one of these individuals has access to comprehensive health care, from preventative dental care to cancer treatment. Our clinicians, case managers, and behavioral health professionals work in more than 30 locations to serve some of our community’s most vulnerable—and most resilient—citizens.

From our earliest days as a program, we have always sought to do work that is transformational: recognizing our shared humanity; centering dignity, compassion, mutual respect and supporting the right of every individual to access the highest levels of health care and every staff member to reach their fullest potential. We continue to be committed to building bridges and breaking down barriers, including systemic racism which harms us all. We provide community-based health care services that are compassionate, dignified, and culturally appropriate, incorporating social determinants of health, with the goal of breaking down the physical and systemic barriers that our patients face.

Bilingual, Bicultural, LGBTQIA-identifying, Black, Indigenous, and People of Color are encouraged to apply.

To learn more about working at BHCHP, watch our video Please Click Here.

Job Summary:

• *NOW OFFERING A $4,000 SIGN-ON BONUS***

Hours: Full time, Monday - Friday 8:30am-5:00pm

BHCHP is seeking a Registered Nurse (RN) who is interested in a dual role working on a new Senior Care Team and in our primary care clinics. If you are interested in a dynamic nursing role within a spirited team that allows you to work in unique clinical settings, this is the job for you!

This is an exciting opportunity for you to have a lasting impact on a team and its patients by being a part of its inception and work in an outpatient clinic setting. For 24 hours per week, you will be a nurse care manager on the Senior Care Team, and the other 16 hours will be as an outpatient nurse in one of our various clinic sites. As a member of the Senior Care Team, you will collaborate with the primary care team to provide specialized care for BHCHP’s senior patients, an ever-growing proportion of the people we serve. This is an outreach position that includes meeting patients in the community, hospitals, clinics, and connecting with them by phone. You will also participate in collaborative decision making for workflows and standards including the assessment tools, documentation practices, and referral processes. In this role, you will exemplify BHCHP’s mission through direct patient care and contributing to program development.

Responsibilities:

• Participates in creating workflows and standards for caring for seniors who have experienced homelessness or are currently experiencing homelessness; provides direct patient care as part of a multidisciplinary outreach team. This includes home visits, outreach to hospitals, homeless shelters, and other settings, as needed.
• Employs a trauma informed and harm reduction approach to caring for patients with a history of serious mental illness and/or substance use disorder
• Implements prevention & engagement strategies in partnership with Senior Care Team members.
• Collaboratively participates as a member of the primary care team that includes Providers, RNs, Behavioral Health Clinicians, Medical Assistants, Case Managers and others; works with the team to determine appropriate health assessments for this program, provide clinical oversight and tracking for comprehensive health assessments for enrolled patients
• Uses data to evaluate outcomes of targeted interventions for panel. Assist in developing appropriate adjustments to care plans based on this data; connects enrollees to various needed supportive services and resources such as visiting nursing, nutrition, and social services.
• Provide all nursing related activities in association with primary care clinical operations at BHCHP primary clinic settings: including direct care and nursing case management activities, immunization and screenings; provide triage and nursing assessment of walk-in and scheduled patients as directed
• Communicates clearly and professionally with other members of the interdisciplinary team as well as with patients and caregivers; conforms to BHCHP standards of performance around patient rights, customer service, infection control, safety procedures and culturally competent care.
• Remains flexible in duties as role expands and is available for assistance with other projects as needed.

Qualifications:

Basic Knowledge/Skills:

• Strong nursing assessment skills
• Interest in working with disadvantaged groups and elder care; understanding of substance use disorder and mental health
• Must be well organized, efficient and can work autonomously and within a team; must be able to collaborate with multidisciplinary teams to achieve best patient care
• Proficient with Microsoft suite and ability to adapt to technological changes
• Timely and strong communication skills via phone, e-mail, and internal secured messaging systems; ability to prioritize and have attention to timetables to complete task
• Willingness to travel to outreach/various sites; valid driver’s license and car required or strongly recommended to travel to multiple sites
• Fluency in Spanish or Haitian Creole, a plus

Education and Experience:

• Licensed as RN in Commonwealth of Massachusetts; 1- 2 years RN experience preferred
• Previous community health center or primary care experience.
• Demonstrated interest in public health, primary and preventive nursing and working with an under-served population
• Experience working with people experiencing homelessness, strongly preferred; mental Health experience, including knowledge of trauma informed care, a plus
• Lived experience, a plus