May be eligible for $20,000 sign on incentive

May be eligible for relocation assistance

May be eligible for tuition loan reimbursement

The incumbent in this position leads a complex, patient centered team- based approach to comprehensive heart failure care. The RN in this position will act as a primary case manager for a selected population of heart failure patients and work within a chronic disease management model of care. As the leader of this team- based patient care, the Heart Failure care specialist will assist patients through transitions of care and navigate patients through the inpatient and outpatient continuum of care.

Essential Job Functions

• Provides daily heart failure education and care coordination of hospital inpatients in conjunction with the physician and advanced practice provider.

• Provides daily phone, tele-assurance, device and pressure sensor monitoring of heart failure weights and symptoms and intervenes appropriately.

• Provides daily education of ambulatory care HF patients on the phone, in the office and enrolls patient in program for closer monitoring, education reinforcement and medication optimization.

• Provides problem resolution for patients and families calling into the office for assist with education, symptom management and care coordination. Promote removal of barriers to care and adherence to recommended treatment plan of care.

• Collaborates with other health care providers in developing, implementing and evaluating heart failure plan of care for patients and their families.

• Daily review of patient assessment findings and intervening appropriately up to and including IV diuretic administration in the office to prevent hospitalization and reduce morbidity and mortality.