Virtual Nurse Health Advisor - PHSO | AdventHealth Corporate
Location Address: Virtual, local to Florida
Top Reasons to Work at AdventHealth Corporate
Day 1 Health Insurance Coverage
Career growth and advancement potential
Full-Time, Monday – Friday
You Will Be Responsible For:
Identify high-risk clients, monitor, assess, and evaluate health care /psychosocial needs, collaborate and coordinate care and services between healthcare providers
Develop plans of care with immediate and long-term goals, organize and implement care management activities, and document interventions and activities consistent with individualized and care management goals.
Adhere to case management standards of practice for case management and follows evidence-based clinical guidelines, incorporates whole person care with CREATION Health model promoting quality care and cost-effective outcomes that enhance physical, psychosocial and vocational health of individuals
Assesses clients/caregiver(s) activation stage, literacy level, and self-management capabilities. Identifies and refers client to appropriate interdisciplinary care team member and/or community resources for identified needs in these areas. Incorporates the assessments and referrals into plan of care.
Facilitates advanced care planning and collaboration with behavioral health services to prevent/avoid unnecessary hospitalizations and/or readmissions.
Educates client and family/caregiver(s) on diagnosis, medications, medication reconciliation, nutrition and moves client toward self-management.
Monitor and document response to interventions and client progress utilizing motivational interviewing to facilitate positive behavior change and meeting goal driven outcomes.
Collaborate with the interdisciplinary care team to develop person-centered care plans that prevent avoidable hospitalizations and ED visits
Provide referrals to LCHWs, Pharmacists, Spiritual, & Community Resources as needed
Accurately submit all required documentation in a timely manner and in compliance with department processes/procedures
Support the population health department and health transformation team goals by providing quality interventions, customer service excellence, and maintaining acceptable attendance, productivity, and caseload expectations
Meet with collaborative care team, Supervisor, Manager, Director of Health Management, and/or Medical Director as scheduled
Participates in committees, teams or other work projects/duties as assigned.
What You Will Need:
Education and Experience Required:
Graduate of a school of accredited nursing
Minimum (5) years of clinical experience as a registered nurse
Licensure, Certification or Registration Required:
Current registration with Florida State Board of Nursing
Current, valid State of Florida license as a registered professional nurse (RN)
Knowledge and Skills Required:
Comprehensive knowledge and understanding of chronic and acute disease conditions, management, and treatment
Ability to interact effectively with health care professionals and clients/caregivers.
Excellent written and verbal communication, interpersonal, critical thinking, and problem-solving skills
Experience with Medicare Shared Services Program preferred
The Nurse Health Advisor coordinates care, educates clients, and provides interventions within the scope of case management practice that have direct influence on clinical and financial outcomes. This position supports the Medicare Shared Services Program (MSSP). It is a dynamic and systemic collaborative approach to providing and coordinating health care services to a defined population across the continuum. Responsibility includes identification of high-risk clients, assessment of healthcare needs, collaboration, and coordination with health care providers and development of plan of care with accurate documentation of these activities. Participates in the process to identify and facilitate options and services for meeting individuals' health care needs, while decreasing fragmentation and duplication of care and enhancing quality and cost-effective clinical outcomes. Actively participates in outstanding customer service and accept responsibility in maintaining relationships that are equally respectful to all.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.