HIV Complex Care Nurse

West County Health Centers (WCHC) is a non-profit health center that provides comprehensive, quality, and accessible health care services to the communities of Western Sonoma County. We are a cohesive team of health care providers, support staff and volunteers dedicated to wellness, compassion, affordability, and excellence of care. We believe in non-judgmental and equal care for all members of our diverse community. Come and be a part of an amazing team!

Want to see more about our mission, who we are, and why you should join our team? Check us out using the links below!

Who We Are: https://vimeo.com/720058024

Our Mission: https://vimeo.com/720057427

Join Our Team: https://vimeo.com/720057373

This position has a $5,000 sign-on bonus!

JOB SUMMARY: The HIV Complex Care Nurse provides comprehensive care coordination and clinical support services for patients living with HIV. Responsibilities include patient assessment, care planning, adherence support, transitions of care coordination, patient education and collaboration with interdisciplinary care teams and community partners. The nurse works closely with the HIV Social Work Case Manager, HIV Program Manager and medical providers to support positive health outcomes and improve access to care.

Essential Function:

• Accepts client referrals from WCHC medical providers to begin coordination of care
• Initiates the intake process for new patients, including risk assessment.
• Coordinates the determination of client needs based on current medical condition, living situation, financial circumstances, personal strengths, adjustment to diagnosis, social support and overall psychosocial status.
• Follows patients at points of transition, including ED to inpatient, inpatient to skilled nursing facility and inpatient or skilled nursing facility to home.
• Maintains confidential records on all client/patient contacts that meet legal and ethical standards.
• Coordinates tracking efforts to assure patients receive care and follow-up on necessary medical visits, outside tests, etc. and at appropriate intervals.
• Maintains ongoing personal contacts with the client, augmented by consultations with referring WCHC provider and review of the client’s medical record.
• Communicates all new HIV diagnoses to the county for surveillance purposes.
• Liaisons with Home Health agencies to establish in-home care and works with the Care Management Assistant for the ordering of DME, home health aides, in-home infusion, hospice, IHSS support, etc.
• Coordinates adherence efforts, including but not limited to, patient education regarding medication, identification of blocks to adherence and coaching on adherence strategies.
• Refers as appropriate to other members of the WCHC HIV team including mental health.
• Participates in a weekly and monthly HIV team meeting and other related meetings. Participates in quality improvement, quality assurance, and innovation activities to ensure optimal level of care delivery at West County Health Centers.
• Works collaboratively with members of the care team to optimize communication, coordinate needed services and meet the needs of the patient.
• Assists in the coordination of warm hand-offs or “Transfer of Trust” between the care team, Behavioral Health Staff, Psychiatry, Wellness, or other support services during the office visit.

MINIMUM QUALIFICATIONS:

• Two to three years nursing experience working with individuals living with HIV/AIDS.
• Current California Registered Nurse License.
• Two to four years of related post-graduate experience.
• This position requires being on site Monday through Friday.
• Experience in ambulatory care, case management, public health or community health.
• Bilingual skills preferred.
• Knowledge of Ryan White program services and community resources preferred

Physical Requirements:

• Ability to bend and move arms with sufficient range of motion to complete patient related requirements, may need to assist patients onto an exam table, must be able to lift up to 30 lbs., bend, kneel and twist as needed and hearing is required for patient assessments.
• Prolonged standing and occasional sitting required.
• Must be able to perform the essential duties with or without accommodations. Must possess basic office and equipment safety knowledge and practice.
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

West County Health Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Type: Full-time

Pay: From $45.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Free parking
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Vision insurance

Physical Setting:

• Clinic

License/Certification:

• RN License (Preferred)
• CPR Certification (Preferred)

Work Location: In person

Salary : $45