Partners w/ the healthcare team, nutritionist & pharmacist to coordinate a comprehensive care plan for patients w/ diabetes; provides self-care education to a targeted population of diabetic members in order to improve disease control.
Essential Functions:
- In partnership w/ pharmacy & nutrition educators, & under the supervision of Regional Diabetes Program; educates patients & families for diabetes self-care:
- Builds relationships w/ teaching partners & Regional Diabetes Managers.
- Promotes, refers to, & advocates the InSTEP program.
- Collaborates w/ teaching partners & Regional Diabetes Program to schedule class dates & times to accommodate center patient population; serves as InSTEP program center lead.
- Conducts group classes using principles of adult learning & the standardized 'InSTEP w/ Diabetes' curriculum.
- Assesses patient status, risk factors, & care needs to include self-management skills & factors/barriers to reducing risk.
- Establishes individual goal plan w/ patient & Provider. Facilitates & helps members develop a realistic personal action plan which promotes self-directed care.
- Evaluates patient's progress towards goals & transitions to self-management once goals are met.
- Documents patient status, goal plan & progress per MAS Regional Diabetes Program Guidelines.
- Assists in evaluation of InSTEP program; completes & forwards required records in a timely manner.
- Actively manages Center Diabetes Registry to identify special needs & to reinforce self-management plan.
- In partnership w/ the Healthcare Team, supports coordination of care of the member w/ diabetes:
- Collaborates w/ & builds relationships w/Healthcare Team Providers, Nurses & others involved in the care & treatment of patients.
- Provides nursing care & or emergency care of the diabetes patient as needed: monitors nutrition, blood glucose records, & laboratory results. Orders appropriate repeat lab studies under Primary Care Provider's name. Adjusts diabetic medication as instructed by the Provider.
- Makes appropriate referrals to pharmacy, case management, etc.
- Liaisons w/ KP Case Management & End Stage Renal Disease Team.
- Trains Healthcare Team RNs to provide 'Survival Skills' self-care education for newly diagnosed diabetics: i.e. insulin self-injection & use of the glucometer.
- Participate in center-based Diabetes Clinic or Comprehensive HealthCare Clinic & in monthly provider/healthcare team meetings.
- Monitors schedule at least twice a week to ensure appropriate utilization of clinical time, & reviews schedule templates on an ongoing basis.
- Assists center quality committees and healthcare teams w/ performance improvement projects & interventions related to diabetes.
- Maintains evidenced-based diabetes knowledge & adjusts practice accordingly.
- Performs other related duties as directed.
Qualifications:
Basic Qualifications:
- A minimum of 2 years orrecent clinical experience to include 1 year in an ambulatory care setting & 2 years of RN inpatient experience.
- Experience and proficiency in care of the diabetic patient required.
- Bachelor's degree required.
- Registered Nurse in specific state or jurisdiction.
- Certification by the National Certification Board for Diabetes Educators (CDE) or a minimum of 2 years of educational or work experience in diabetes, adult learning principles and behavioral strategies can be initially substituted for certification.
- CDE certification must be obtained within 2 years of employment in the position.
- Current CPR certification is required.
Preferred Qualifications:
- Case Management experience preferred.
- Bi-lingual skills Spanish is highly desirable.
- Master's degree preferred.
- Membership in the American Diabetes Association and the American Association of Diabetes Educators preferred.
- This position is within the Alterative Medicine department
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.