Registered Nurse, Clinical Guide
3 days ago
Engage with members and understand their needs - use technology and data to better understand the member and any unspoken needs.
Conduct holistic assessment to identify co-morbid conditions, ED/ hospitalization history, medications, psychosocial factors, and their values and preferences.
Collaborate with our PCP partners.
Develop care plan in partnership with the member and their caregivers - problems, goals, interventions - continuously evaluating the member’s progress in meeting their goals.
Apply knowledge to suggest safe exercise routines, dietary plans, meditation or stress reduction techniques
Work closely with Local Service Guides to identify community-based organizations able to support the member in meeting their goals.
Collaborate with members, providers, and caregivers to ensure a positive outcome.
Explain complicated medical terms in plain language.
Educate the member on appropriate care and settings based upon their healthcare needs.
Support members in understanding diagnostic tests and treatments, including costs, risks, and alternatives so they can make an informed decision about their care needs.
Prepare members for their inpatient and outpatient treatments and coordinate any care needed post-treatment.
Support and coach members to improve management of their chronic condition, including medication adherence and compliance.