Job TitleKnowledge in all aspects of the electronic medical record, including training and monitoring for compliance and timely follow-upResponsible for the daily nurse visit schedule that includes billing and charting in a timely mannerCompletes telephone and on site Triage, facilitating patient questions and answers for behavioral health and medical patients. Supports monitoring of patients awaiting behavioral health appointments as identified for follow-up by the PCP.Coordinates care management for identified patient populations assigned to designated providers, including medical and behavioral health patients.Provides case management for patients identified through the care team, developing coordinated plan of care to improve health outcomes of patientAnalyzes preventative screening data for designated patients, providing guidance to clinical support and providers for upcoming visits through onsite and electronic huddles.Provides feedback to nurse manager regarding team member's patient centered medical home activitiesParticipates in quality improvement, in-service workshops, continuing education and peer review as requested by management and supervisionAssist with and promote all processes associated with the Coleman initiativeAssist with and promote all processes associated with Patient Centered Medical Home standardsAny other duties and responsibilities as requested by management and supervisionRequirementsGraduate of an accredited RN nursing programCurrent New York State license in Registered NursingCompletes additional training for care management, SBIRT, Depression and Anxiety screening to support assessments for mental health and substance use disorder patients as applicableDemonstrate a willingness to accept direction from providers and Sr. VP/ CNQOPossess the ability to work well and with compassion in stressful situationsMaintain a professional and courteous demeanor with both patients and co-workersBe keenly aware of the importance of confidentiality in all aspects of the position