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Transition of Care Nurse Practitioner

Company: Portneuf Medical Center
Location: Pocatello
Posted on: May 1, 2021

Job Description:

Who We Are

Patient focused, community oriented, conveniently located and equipped with technology that rivals the nation’s most prestigious healthcare systems, Portneuf Medical Center offers a comprehensive and growing array of services delivered by caring and highly skilled medical professionals.

 Our mission statement “World Class Care, every patient, every time” helps us focus on what truly matters: You. And our commitment is to make sure our patients receive amazing care every time they have contact with Portneuf Medical Center. The physicians, nurses and volunteers who are a part of the Portneuf family are your friends and neighbors. We're your community, your hospital and team, working hard for you.

 We are looking for a dynamic and passionate Pre-Access Nurse Practitioner to join our team!

What You’ll Do

The Pre-Access Nurse Practitioner will provide support to patients as they move from an acute hospital level of care to home, or other post-acute level of care.Working closely with the ISU Faculty and residents, the TOC NP initiates early contact with patients post hospitalization, coordinates care and follows the patients along the continuum of care to assist the patient in avoiding unnecessary readmission to an acute
care hospital.  The TOC NP will identify, track, and trend data related to clinical resource  management, readmission and quality/risk
issues that impact patients and their clinical, financial and quality outcomes.. The successful candidate will be able to:

  • Identifies patients at high risk for readmission based on LACE scores
  • Identifies patients  with a need for early intervention related to discharge education and transitional care, documents education and plan of care in a tracking tool. Includes  the education of patients and families regarding components of discharge instructions and available community resources as necessary.
  • Has a key role in the clinical training of Family Medicine Residents and NP students.
  • Assists nursing staff, case managers and Home Health Coordinator in setting appropriate discharge goals; collaborates with patient, family and physician.
  • Identifies actual and potential issues related to readmission and collaborates with interdisciplinary team members to resolve these issues when necessary.  This includes collaboration with physicians, residents and nurse coordinators at Health West Clinics.
  • Regularly reviews and analyzes external data relevant to care management and readmission process.
  • Collect detailed data on the patients followed and present data to leadership team including the UR committee.

What We Offer

 Competitive pay and benefits package including Health/Dental/Vision/401(k) match. Generous paid time off, holidays, extended illness bank, paid basic life insurance and long term disability.  

Portneuf Medical Center is an Equal Opportunity Employer


What You’ll Bring

  • Nurse Practitioner or Advanced Practice Registered Nurse
  • Minimum of 2  years clinical experience as NP or APRN,  5 years preferred
  • Hospital, and/or  home heatlhcare experience required;  Case Management, or management experience is preferred. 
  • Strong organizational and communication skills both written and verbal.  Must have the ability to function with a high degree of autonomy.
  • Must be highly self-motivated with positive attitude,  flexibility and prioritization abilities.
  • Must be able to write reports and make use of data to provide clear goal setting for area of coverage; computer skills are required.

Keywords: Portneuf Medical Center, Pocatello , Transition of Care Nurse Practitioner, Other , Pocatello, Idaho

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