RN Preceptor (Advanced Illness Management) Job Listing at Sutter Care at Home in San Francisco East Bay and Solano, CA

Home Health Care, Pharmacy

On any given day, Sutter Care at Home touches the lives of thousands of individuals by bringing health care directly to patients where they live - at home. From local, community-based offices throughout Northern California, the dedicated staff at Sutter Care at Home cares for more than 50,000 patients each year and serves an average daily census of over 18,000 patients. We provide the most comprehensive range of home care services including skilled nursing, rehabilitation therapy, home infusion therapy, hospice and palliative care, medical social work, home medical equipment and respiratory therapy, home attendant and care management, and community flu and wellness programs. Through competitive wages and benefits, flexible schedules, innovative care models, new technologies, and tuition reimbursement - Sutter Care at Home strives to be your "employer of choice." Sutter Care at Home is the home health care and hospice affiliate of Sutter Health, one of the nation's largest not-for-profit health care systems. The AIM implementation is a three-year Health Care Innovation Award funded by the Center for Medicare Medicaid Innovation. AIM is a patient-centered and evidence-based model of care for patients with advanced illness that is specifically designed to address the gaps in our current health care system that these patients routinely experience. Through this project, Sutter hopes to clearly show that AIM is a highly effective, replicable, scalable model that can be implemented nationally. AIM provides nurse-led care management, palliative care, and advance care planning for patients with late-stage chronic illness. AIM is provided at no cost to patients and their families. The expansion of AIM system-wide will provide additional services to coordinate care across the network for patients with advancing chronic illness.

The AIM Preceptor is responsible for assessment, evaluation and coaching of AIM field staff. He/she provides direct guidance to the AIM staff relating clinical practice development, education, quality performance improvement and clinical integration at the point of care level, usually in the form of joint visits. The AIM Preceptor makes recommendations based on observations of AIM staff at work, developing corrective plans to ensure all core competencies of the AIM care are delivered. The AIM Preceptor models the shared principles in AIM with those of the Integrated Care Management program. This individual participates in interdepartmental and intradepartmental staff education programs, committees and in-services; advises on policies and procedures related to AIM care interventions; and collaborates with other disciplines to develop and provide patient/family education resources. The AIM Preceptor partners with AIM Leadership to improve clinical and operational performance. He/she will also assume the role of field clinician when full time preceptor needs are currently achieved at a regional level; this direction is decided jointly by local/regional and central management and remains fluid for this role.

This position requires a working knowledge of Medicare Conditions of Participation for home health care and hospice, California Department of Health Title XII regulations, JCAHO home care accreditation standards, OIG Work Plan and HIPAA regulations in addition to knowledge of population with advanced illness care needs.