A Registered Nurse provides medical care and treatment, educates patients about their conditions, and provides emotional support to patients and families. Works in hospitals, schools, clinics or community health centers. Works under the supervision of a physician or other specialist, and serves as the primary point of care for patients in a hospital setting. May specialize in emergency room work, or treatment for a particular condition, or specialize in working with infants, the elderly or other patient groups. May work as an advanced practice specialists and prescribe medications in addition to offering specialty care.
Summary The Registered Nurse (RN) Annual Wellness Visit Coordinator manages and conducts Medicare Annual Wellness Visits (AWVs) while driving preventive care and care gap closure. This position supports value-based care initiatives like Aledade and Patient-Centered Primary Care Home (PCPCH) programs to improve patient outcomes within an interdisciplinary clinic team. Core Duties & Responsibilities Clinical Care & Wellness Visits Conduct initial and subsequent Medicare Annual Wellness Visits using CMS guidelines. Complete health risk assessments, medical/family histories, and personalized prevention plans. Counsel patients on healthy lifestyles, chronic disease prevention, and vaccines. Utilize approved standing orders and clinic workflows to streamline preventive care. Pre-Visit Chart Scrubbing & Screening Coordination Perform detailed pre-visit chart scrubbing to pinpoint missing clinical data. Flag outstanding quality gaps and preventive services prior to patient arrival. Target and schedule patients for required age- and risk-appropriate screenings. Coordinate mammograms, cancer screenings, depression, fall risk, and cognitive assessments. Manage Advance Care Planning and mandatory patient immunizations. Care Coordination & Quality Improvement Communicate care gaps and preventive recommendations directly to physicians and mid-level providers. Drive clinical performance to meet Aledade quality measures and PCPCH initiatives. Monitor, analyze, and report on AWV completion rates and clinic productivity. Participate actively in process improvement initiatives to maximize team efficiency. Documentation & Compliance Maintain accurate, comprehensive, and timely clinical documentation within the EHR system. Ensure all charts meet CMS, Medicare, credentialing, and internal compliance policies. Carry out essential functions independently, establishing priorities based on clinic needs. Qualifications & Requirements Education & Licensure Oregon Registered Nurse (RN) License active and in good standing. Current Basic Life Support (BLS) certification from the American Heart Association. Experience & Skills Familiarity with Medicare quality metrics, ACO frameworks, or PCPCH models preferred. Proficiency working inside Electronic Medical Record (EMR) platforms. Strong interpersonal communication skills for patient education and medical team collaboration. Physical Requirements & Working Conditions Normal clinical environment with potential exposure to bloodborne pathogens. Ability to lift up to 250 pounds for patient transfer with staff assistance. Ability to carry items up to 25 pounds and push/pull between 50-250 pounds. Routine standing, sitting, reaching, bending, and standard manual office equipment operation. Capacity to effectively manage situational and customary inherent work stressors. If you are interested in joining the Grants Pass Clinic in this exciting new role, feel free to apply on our website at https://www.grantspassclinic.com or by replying to
Indeed Pay:
$90,000.00 - $97,000.00 per year
Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Flexible spending account Health insurance Health savings account Life insurance Paid time off Vision insurance
