High Risk Health Coach RN

Job description

Employment Type: Full time Shift: Description: Remote Position - Must live in Iowa Job Summary: The RN Ambulatory Health Coach provides care management and care coordination services to Population Health patients with complex illnesses residing in the community setting. This includes managing a panel of high-acuity patients, managing their transitions in care across the care continuum, and providing coaching and education to support patient self-management. Serves in an expanded health care role to collaborate with the patient’s primary care provider, specialists, other members of the health care team, and patients/families to ensure the delivery of quality, efficient, and cost-effective health care services. Assesses, plans, implements, coordinates, monitors, and evaluates all options and services with the goal of optimizing the patient’s health status. Integrates evidence-based clinical guidelines, preventive guidelines, and protocols in the development of individualized care plans that are patient-centric, promoting quality and efficiency in the delivery of health care. Understands and complies with PHSO standard work flows, upholding accreditation level standards. Essential Pos...