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Value Based Care Specialist

Cape Cod Healthcare

Vineyard Haven, MA
Job Code:
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Cape Cod Healthcare
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Job Details

Value Based Care Specialist-171223-50006388
Assist Team Leader with staff and care management that will ensure optimal Value Based outcomes and patient centered care coordination. Assist in oversight of assigned clinical team. Perform comprehensive nursing assessment upon admission of the patient, integrate data and identify problems that form the basis of a plan of care.
  • Per delegation of Team Leader, draft and perform Annual Evaluations of Field Staff.
  • Assist with the orientation and preceptor program for new hires.
  • Conduct co-visits to ensure and enhance staffs ability to develop patient centered plan and to coach patient through adherence challenges.
  • Perform chart audits of clinical team to assess and ensure value based measures are being met and identify opportunities to mitigate challenges.
  • Provide assistance to Team Leader with other duties to include, complex case management, collaboratively reviewing and triaging incoming referrals, and collaborating with other Value Based providers in the patients continuum to ensure consistency in the patient centered plan.
  • Complete admission and other paperwork on a timely basis. Record narrative documentation to reflect skilled care.
  • Instruct and provide documented supervision of the CHHA plan of care every 14 days.
  • Utilize HHRG values to establish visit frequency and to establish appropriate interdisciplinary utilization.
  • Assure that annual outcomes meet National Benchmarks.
  • Assume delegated responsibilities in the absence of the Team Leader.
  • Assist Team Leader in the hiring, direction and discipline of team members.
  • Other duties as assigned.

  • Registered Nurse currently licensed in Massachusetts required.
  • Two years homecare experience.
  • Oasis certification preferred or willing to become Oasis certified.
  • BSN preferred.
  • CPR required.

Schedule Details: position can be 30 or 37.5 hours per week
Organization: Visiting Nurse Association
Primary Location: Vineyard Haven
Department: VNA-RN Salary MN
Employee Classification: Regular-Regular
Shift: Day
Weekend Shifts: None
Holiday Shifts: None
Posting Start Date: Dec 27, 2017
Posting End Date: Ongoing
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