RD/Diabetes in Pregnancy Case Manager (DH1623) - Tuba City Regional Health Care Corporation

Navajo Preference Employment Act :In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act.  Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.Overview:

POSITION SUMMARY

This position is to provide registered dietitian case management, care coordination, medical nutrition therapy, and diabetes self-management education, utilizing Sweet Success and Beautiful Beginnings curricula, to pregnant women who have either pre-existing diabetes or gestational diabetes. Additional responsibilities include providing prenatal medical nutrition therapy to all pregnant women to improve outcomes for women and infants. This position will also provide interventions and referrals to high-risk post-partum women and their infants with the goal of preventing diabetes and obesity. The goal of this position is to provide quality health care, limit fragmented care, enhance the patient’s self-care and quality of life, and improve both short-term and long-term maternal and child outcomes. The incumbent will also provide diabetes self-management education and medical nutrition therapy to patients in the Healthy Living Center and women’s and pediatric clinics. The incumbent will provide inpatient medical nutrition therapy to patients with and without diabetes on a rotating weekend/holiday on-call schedule. This position is grant-funded.

Qualifications:

NECESSARY QUALIFICATIONS

Education:

Bachelors of Science degree in Dietetics

Certification:

• Must be a Registered Dietitian in good standing with the Commission on Dietetic Registration
• Must have and maintain a current valid certification of the following throughout employment:
  • Basic Life Support (BLS) from the American Heart Association

Experience:

Must have two (2) years of work experience as a clinical dietitian in an outpatient setting, with the majority of experience in diabetes self-management

Other Skills and Abilities:

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers.  All employment references must address and indicate success in each one of the following areas:

• Positive working relationships with others; cooperating effectively in teams for the benefit of patient care
• Possession of high ethical standards and no history of complaints
• Reliable and dependable; reports to work as scheduled without excessive absences
• Effective verbal and written communication skills; exceptional communication and interpersonal skills are essential
• Ability to prioritize duties and work independently; must be self-motivated
• Experience with Microsoft Office and other computer applications
• Completion of and, above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading, or incomplete information, as determined by TCRHCC.

 

MENTAL AND PHYSICAL EFFORT

The physical and mental demands described here are representative of those that must be met by an individual to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical:

This position requires an individual of high energy who can maintain a long and flexible schedule to meet the management requirements. The physical requirements include; sitting long periods of time, frequent walking to interact with staff within the facility, occasionally driving, climbing bending, kneeling, crouching, and twisting, Must be able to frequently maintain balance and reaching. Must be able to hear, speak and comprehend over the telephone and in person with others. Must have ability to lift to 35lbs, and, push and pull up to 10lbs frequently. Sensory requirements for position include prolonged ability for far, near, and color vision, depth perception, seeing fine details, hearing normal speech, telephone use and ability to frequently hear overhead pages. Must have ability of both hand manipulation in simple and firm grasping, fine manipulation, and use of keyboard.

Mental:

Uses independent judgment and analytical skills to make decisions that impact operations, finances, and customer service within the organization.  The incumbent must have the ability to perform in structured and unstructured environments and possess a keen attention to detail and propose practices/mechanisms to enhance customer satisfaction. Must have ability to continually concentrate, handle a high degree of flexibility, handle multiple priorities in stressful situation, demonstrate high degree of patience, adapt to shift work, work in areas that are close in crowded, frequently cope with high levels of stress, make decisions under high pressure, work alone, and occasionally cope with anger/fear/hostility of others in a calm way and manage altercations.

Environmental:

May frequently be exposed to chemical agents, extremes in temperature and humidity, occasional exposure to infectious diseases, dust, fumes, gases, hazardous or moving equipment, and loud noises.

Responsibilities:

ESSENTIAL FUNCTIONS

1. Case manages patients with diabetes in pregnancy by tracking new diagnoses, scheduling initial and follow-up appointments, completing and documenting telephone and mail contacts, and coordinating post-partum follow-up appointments and intervention referrals. Needs to be flexible to meet the patient at non-scheduled visits and track utilization of other health care services as appropriate. Ensures patients receive recommended services and follow-up to improve both short-term and long-term outcomes.
2. Collects data on diabetes in pregnancy outcomes using Excel spreadsheet and TCHRCC Diabetes in Pregnancy registry for the Navajo Area Indian Health Service Sweet Success program. Reports data a minimum of annually.
3. Tracks and reports productivity using patient contacts and outcomes on a daily, weekly, and monthly basis.
4. Attends and participates in periodic Sweet Success meetings. Travel may be required.
5. Performs individual patient needs assessment to evaluate intervention priorities. Assesses patient needs, self-management abilities, psychosocial concerns, learning factors, mental and emotional health status, access to health care resources, and glycemic control.  Provides appropriate level and frequency of care for patients and their families as identified in the individual assessment.
6. In collaboration with the patient, family, and health care team, identifies realistic and appropriate interventions and goals based on needs assessment. Supports the patient in completing the intervention and meeting goals.
7. Applies the ADA and IHS Diabetes Standards of Care.
8. Provides medical nutrition therapy and diabetes self-management education to pregnant women with diabetes, either pre-existing or gestational, using the “Sweet Success” and “Beautiful Beginnings” curricula in both individual and group settings. This education will necessarily include, but not be limited to, management of self-monitoring of blood glucose (SMBG), medications, exercise, and nutrition.
9. Applies theoretical approaches such as motivational interviewing, stages of change theory, and empowerment theory to facilitate behavior change. Effectively communicates with patients and families in a culturally sensitive manner.
10. Provides medical nutrition therapy and weight management support to high-risk pediatric patients and their families.
11. Provides medical nutrition therapy to women’s clinic patients, with an emphasis on early prenatal nutrition therapy.
12. Monitors self–monitoring blood glucose (SMBG) data, Continuous Glucose Monitoring (CGM) devices and medication therapy in combination with the nutrition and exercise plan to maintain glycemic control. If adjustments or initiation of medications are indicated, consults with the patient’s obstetrician or nurse-midwife to formulate treatment plan.
13. Serves as a clinical expert and resource on diabetes in pregnancy to Women’s Clinic and HLC staff. Initiates and develops in-service training to staff to keep staff updated on issues pertaining to diabetes in pregnancy.
14. Provides inpatient medical nutrition therapy to patients with and without diabetes on a rotating weekend/holiday on-call schedule.
15. Assists with Performance Improvement initiatives for continuous quality improvement and improved maternal and child outcomes.
16. Prepares patient education materials as needed, seeking approval for use of new or updated materials through the Patient Education Materials Committee.
17. Employs the American Association of Diabetes Educators AADE7 Self-Care Behaviors framework.
18. Maintains confidentiality regarding administrative and patient related care.
19. Maintains current licensure and job competencies, and knowledge of evidence-based guidelines through active participation in continuing education, independent study, in-services, seminars, and dialogue with colleagues.
20. Ensure Proper PPE is used at all times while on duty. Face surgical mask is to be worn in all hospital areas. Proper handwashing is required. If water is not available use hand sanitizer. Social distancing will be practiced by department. 
21. Proper PPE is used inside assigned Clinics or Units. NIOSH- approved N95 Masks filtering face piece respirator or higher, if available, this includes eye or face shields, gloves, and isolation gowns.
22. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. Complete provided training.
23. Completes all electronic health record entries accurately and timely pertinent to patient care role.
24. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives.
25. Performs other duties as assigned