Registered Nurse Care Manager - OBAT

Our Culture : Why work with us?

Joining Outer Cape Health Services isn't just about taking on a new role; it's about embracing a mission that goes beyond the day-to-day.

Here, you become part of a dedicated team committed to safeguarding and nurturing invaluable community health resources.

Our ethos is built on creating a vibrant and inclusive workplace where every team member is valued and recognized for their unique contributions.

Who We Are :

Our mission is to provide a full range of primary health care and supportive social services that promote the health and well-being of all who live in or visit the ten outermost towns of Cape Cod.

OCHS now cares for more than 18,000 patients annually, and no one is denied access to services due to an inability to pay.

Founded in 1987 through the merger of Health Associates of Provincetown (established in 1972) and the AIM Medical Center in Wellfleet (established in 1966), Outer Cape Health has a long history of successful growth and expansion in pursuit of this mission.

As a Patient-Centered Medical Home, OCHS holds itself to the highest standards. Ensuring patients have access to care when they need it and request it, and validating that staff are working at the top of their licensures, are foundations of this model.

Our Core Competencies :

At Outer Cape Health Services, our core competencies are the foundation upon which our organization is built, guiding us in our mission to deliver exceptional health services to our communities.

Our focus on fostering teamwork ensures that we operate as a cohesive unit, valuing each member's contribution and working synergistically towards common goals.

Integrity and honesty stand at the heart of everything we do, creating a culture of trust and respect among our team and the communities we serve.

Embracing technology, we continually seek innovative solutions to enhance our services and operations. Finally, being patient-centered, we prioritize the needs and well-being of those we serve, striving to exceed expectations and make a meaningful difference in their lives.

A day in the life of this role :

The RN Case Manager - OBAT works with other OBAT team members, Primary Care Provider(s), Behavioral Health Provider(s), substance use counselor(s) and case managers.

The OBAT RN and Complex case manager educates and monitors patients in addiction treatment or; documents visits in the electronic medical records (EMRs);

and is responsible for maintaining statistical information chosen by the OBAT team. They also perform outreach to high risk ACO patients for complex care management and care coordination.

This position will travel between sites.

Summary of duties :

• Monitor and obtain client's UDSs and lab tests as dictated by the OBAT program's guidelines.
• Monitor patient compliance with programs rules, including diversion of medication and attendance at required counseling, PCP (medical appointments), group and psycho-pharmacology appointments.
• Work with prescribing provider(s) so medication orders remain on track per OBAT program protocols.
• Evaluate and screen potential patients for the OBAT program.
• Coordinate intake appointments with providers and other medical appointments.
• Provide case management for patients within the scope of the OBAT Program and the Complex Care Management program for the ACO.
• Provide outreach for patients who are missing appointments, transition of care follow-up, and routine check-in for higher risk patients
• Meet weekly or as appropriate with patients for care coordination, to review labs, appointments, urine UDS results, and to give clients weekly / biweekly / monthly prescription dosing with frequency determined by prescribing physician.
• Act as patient advocate.
• Facilitate / participant in developing / implementing patient behavioral contracts.
• Primary contact person for OBAT patients and complex care management patients.
• Coordinate immunizations, specialty and primary care providers, administer medications in the clinic, apply and read PPDs, perform POC urine pregnancy test, or other labs needed as per Policies and Procedures.
• Travel between clinics
• Other related duties and projects as assigned

Work environment :

Travel required to all sites

What we need from you :

• Registered Nurse with current Massachusetts license.
• Bachelor's Degree preferred
• Two plus years nursing experience required, community health care setting preferred
• Interest and / or experience working in the mental health and / or addictions field
• Certified Addiction Registered Nurse (CARN) preferred / willingness to obtain
• Basic life support certification required
• Ability to work in a fast-past environment with complex patient populations, including patients with personality disorders, chronic pain issues, addictive disorders and co-occurring disorders.
• Ability to travel between sites and has reliable transportation
• Ability to establish and maintain strong, effective and therapeutic relationships with patients.
• Promote / educate patient and staff on harm reduction, and substance abuse.
• Ability to be courteous, efficient, effective, and patient in a fast paced environment
• Outstanding organizational skills
• Excellent written and verbal communication skills - bi-lingual helpful
• Proficiency in computer skills including EPIC, Outlook, Microsoft office, OneDrive etc.
• Excellent judgment and ability to solve problems in a timely manner.
• Ability to adhere to strict confidentiality standards.
• Demonstrated ability to work effectively both as a team member and independently.
• Demonstrated ability to work in a culturally diverse and inclusive environment

AAP / EEO Statement Outer Cape Health Services is committed to a firm policy in favor of equal employment opportunity and will abide by all applicable state and federal regulations by not discriminating against any applicant or employee on the basis of race, religion, color, creed, sex, age, national origin, citizenship status, marital status, sexual orientation, gender identity and expression, disability or veteran status.

Our commitment to equal employment opportunities shall include employment, upgrading, promotion, demotion, transfer, leaves or other absences from work, layoff, compensation and benefits, selection for training or other education, professional opportunities and conflict resolution.

It is also the policy of OCHS to take affirmative action to employ and to advance in employment, all persons regardless of their status as woman, minority or individuals with disabilities or protected veterans, and to base all employment decisions only on valid job requirements.

Please inform us of any necessary accommodations required during the application process and / or at any time during employment.