Complex Care Nurse

Written by jtranford - - Comments Off on Complex Care Nurse
Harbor Health
November 4, 2021
Mattapan, Massachusetts
Job Type


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Complex Care Nurse


Plymouth, MA, US

3 days agoRequisition ID: 1711

The Complex Care Nurse provides nursing services at the top of the incumbent’s license to patients in accordance with all applicable Massachusetts State Laws as well as regulations promulgated by the Department of Public Health and Harbor Health Services, Inc. The Complex Care Nurse ensures our High Risk Patient population (primarily our Office Based Addiction Treatment (OBAT) program patients) are properly managed including, referrals, consults, tests, medication management, and patient education to ensure or move toward optimal wellness.

Essential Functions: 
• Ensures High Risk Patient population (OBAT, Complex Care) is properly managed including, referrals, consults, tests, medication management, and patient education to ensure or move toward wellness.
• Ensures High Risk Patients have a completed care plan and documents in the EMR
• Acts as Health Educator for Complex Chronic Disease population (HIV, Hep C etc.)
• Completes at least 16-20 scheduled patients facing clinical hours per week of individual or group visits.
• Assists providers and Care Team members in caring for patients and acts as liaison between the patient and the care team.
• Performs routine nursing care to patients, while utilizing age specific guidelines and standard precaution practices at all times.
• Performs patient teaching for all patients and families.
• In conjunction with team and/or provider, assists in the development and implementation of a comprehensive plan of care.
• Assists providers with on-going assessments and evaluates needs and interventions based on the current status adjusting the care plan as required assuring compliance and understanding of the long-term plan.
• Communicates with all staff, patients, and families demonstrating excellent written and verbal skills.
• Maintains knowledge of all medications, reactions, documentation, and dosage requirements.
• Triages patients as needed.
• Supports transitions of care through nurse visits after ED/Hospitalizations as appropriate.
• Actively participates in the manual and automated clinical tracking programs to ensure compliance with clinical outcome measures, prevention and follow-up care.

Required/Preferred Education, Experience and Skills: 
• Current MA Registered Nurse (RN), BSN preferred.
• 2-5 years of experience working with OBAT/Addiction patients highly desired.
• Excellent customer service and verbal and written communications skills.
• Ability to effectively work within both a team setting and independently
• Ability to work effectively with economically, racially and linguistically diverse customers
• Intermediate computer literacy (basic knowledge of keyboarding, and use of the mouse, scheduling software, principals of windows and Microsoft Office)
• Experience in a ambulatory and/or community health setting and experience in medical case management in acute care preferred.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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