NACC’s mission is to promote the health & wellness of mind, body, and spirit of Native American families. We offer a full range of healthcare services that include Medical, Behavioral Health, Dental, and Substance Abuse. The ideal candidate should have experience organizing, monitoring work performance and progress, clinical experience in community care, and population health management. This position reports to the Clinic Manager and assists in the assessment, planning, implementation and evaluation of patient care to a culturally diverse population. The RN will assist in providing nursing care in an outpatient ambulatory setting. Candidates must possess strong communication and organizational skills as well as the ability to resolve workplace issues effectively.

Primary Care Essential Functions:

Responsible for managing patient phone calls and patient triage (phone and walk in) including but not limited to communicating abnormal labs and other orders directed by providers.

Assists in coordinating vaccine programming, activities, and events while complying with NACC policies and procedures. This may include administration of vaccines in clinic as needed.

Manages prescription refills and durable medical equipment using standing orders and provider direction.

Manages incoming paperwork for home health and external orders.

Responsible for performance improvement and reporting related to RN or LPN functions, including prenatal, pediatric, asthma and diabetes care treatment and indicators.

Responds to medical emergencies and incidents involving patients.

Responsible for maintenance of the crash cart, medication disposal program, and sample medications.

Works with NACC’s leadership team to carry out projects as they relate to the nursing team.

Attends regular meetings with Medical Director, care coordinator and medical teams for planning and reporting.

Participates in work groups as requested.

Other related duties requested by Clinic Manager.

Care Management:

Responsible for the coordination of care for clinic patients. Duties may include, but are not limited to population management and tracking of patient engagement in care; scheduling patient appointments, imaging, transfers of care and hospital admissions; navigating referrals to specialists: coordination of outpatient/inpatient continuity of care; tracking of high-risk patients and abnormal test results

Conducts nurse-led visits through the utilization of clinic standing orders. Nurse-led visits include planning. intake visit, complete physical, and routine follow-up visits.

Perform assessment of patient's unmet social needs and help patients navigate community resources including classes, services, WIC, dental care, nutritionists and other social services as needed.

Completes accurate, timely documentation of patient encounters in the electronic medical record. Documentation and records requirements include completion of office visit notes, updating patient care sheets, acquiring records and closing patient charts according to clinic protocol.

Conduct population management outreach phone calls to promote engagement in care for patients lost to follow-up. Population calls can include rescheduling missed appointments, follow-up, and non­ engagement calls.

Perform other program duties as requested to ensure the delivery of high quality, accessible care. Duties include, but are not limited to, maintenance of patient educational material and coordination of supplies in clinic.

Education and/or experience: Minimum 2 year experience providing direct patient care services in clinic setting; previous experience working with Native Americans or other marginalized communities preferred.

Certificates, licenses and registrations required : Registered Nurse (RN); active, unrestricted license to practice in Minnesota; BLS CPR; proof of current COVID-19 vaccination.

Computer skills required: Internet Software; Spreadsheet Software (Excel); Word Processing Software (Word); Electronic Mail Software (Outlook); Presentation software (PowerPoint); experience using EMR preferred.

Other skills required: Works well independently and on a team; excellent communication, customer service, and case management skills.