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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 The Utilization Review (UR) Nurse ensures that patients receive appropriate care by verifying medical necessity, confirming the correct patient status, and monitoring the ongoing need for services while working to reduce unnecessary length of stay and prevent delays; they support accurate clinical documentation for proper reimbursement, coordinate with providers and the care team on discharge planning and transitions, manage resource use to control costs, communicate with payers to prevent denials, and ensure compliance with CMS and Joint Commission requirements while contributing to reporting and quality improvement efforts. They also serve as a key liaison between clinical care, finance, and regulatory requirements, helping align patient care with both quality standards and reimbursement rules. Ultimately, their role has a direct impact on patient outcomes, hospital efficiency, and the organization’s financial performance. Qualifications NECESSARY QUALIFICATIONS Education: Bachelor’s Degree in Nursing License/Certification: A valid, current, full and unrestricted Professional Nursing License to practice as a Registered Nurse (RN) in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association (AHA) throughout employment Experience: Three (3) years of clinical nursing experience performing direct patient care with at least 2 years in an Inpatient setting on a medical-surgical unit, PACU, or higher acuity Inpatient unit (ICU, Step-Down, Telemetry, etc.) or home health (direct care) {clinical experience qualification may be determined by hiring manager/director.} Demonstrate knowledge of case management, purchased referred care and utilization review Demonstrate knowledge of electronic health record systems. 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Effective verbal & written communication skills Team management focus promoting a positive and pro-active approach to problem resolution Experience in hospital-based utilization review Proficient or experienced with clinical criteria sets for Miliman Care Guidelines(MCG) Completion of and receiving above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewers 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 employee to successfully perform the essential functions of this job. Reasonable accommodation 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 at a desk for long periods of time, long periods of sitting in meetings; frequent sitting for intense work on a personal computer, frequent walking to interact with staff within the facility, frequent bending, kneeling, crouching, twisting, maintaining balance and reaching. Must be able to hear, speak and comprehend over the telephone and in person with others. Must have ability to lift, push and pull up to 50lbs 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 of humidity, occasional exposure to infectious diseases, dust, fumes, gases, hazardous or moving equipment, and loud noises. Responsibilities ESSENTIAL FUNCTIONS Adheres to most current ACMA Case Management Standards of Practice and Scope of Services Adheres to ANA Nursing Scope and Standards of Practice Adheres to most current ANA The Code of Ethics for Nurses Coordination of service specific assessments, service planning and enrollment. Works with all facets of the Case Management continuum, i.e., social support, alternate resources, community referrals, discharge planning, Nursing Home/Skilled Nursing Placement and resource utilization. Comprehensive and client centered service planning and coordination Works proactively with the established RN Case Managers/ Social Workers of TCRHCC as a team member for care coordination of the patient populations served by TCRHCC. Consistent and on-going case consultation with all direct service providers. Developing and maintaining internal and external resource relationships. Promote patient advocacy Promote quality of care Promote cost effective medical outcomes Promote appropriate admission status Provide continuity of care between utilization management and care coordinators Commits to professional development towards becoming an expert in utilization management including but not limited to: Knowing Medicare rules and regulations related to utilization Knowing payor policies related to utilization management Knowing TCRHCC 638 policies related to utilization management. Keeping abreast of current changes affecting utilization management as applicable. Collaborates with attending physician if ambiguous documentation pertaining to patient status placement requires clarification. Utilizes electronic utilization management database for documentation of interventions and communications (MCG Guidelines, Careport and Allscripts) Reviews precertification requests for medical necessity for all payors as applicable, referring to the second level physician reviewer those that require additional expertise Collaborates with payor utilization management liaisons and medical directors as applicable. Uses clinical and analytical skills to review and interpret diagnostic test results to determine appropriateness of patient's level of care. Assists with the development of department reports, policy/procedures manuals, and program objectives Conduct system and procedural efficiency evaluation to determine progress, performance, and conformity with program requirements. Will provide a consistent and on-going collaboration through communication with service providers. Facilitates appropriate clinical documentation to ensure that the level of services and acuity of care are accurately reflected in the medical record. Improves the overall quality and completeness of clinical documentation by performing admission/continued stay clinical reviews using clinical enhancement guidelines for selected patient populations. Reviews clinical issues as needed with the coding staff to assign a working DRG to reflect any changes in patient status and procedures/treatments and confers with the physician to finalize diagnoses. Conducts timely follow-up reviews of clinical documentation to ensure that issues discussed and clarified with the physician have been recorded in the patient’s chart. Participates in review and analysis of monthly data relating to clinical quality documentation and insurance medical necessity criteria. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Completes all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updated) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction. Performs other duties as assigned.

2 weeks ago

Nurse Case Manager - Sign On Eligible

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 Incumbent serves as an Outpatient/Inpatient Nurse Case Manager for TCRHCC and at Sacred Peaks Healthcare Center (SPHC) as the supportive contact for specified groups of identified high risk patients; will specifically focus on specialty clinics that need specific Case Management attention. The case manager meets essential health and social needs for patients while ensuring quality, cost effective healthcare. The case manager facilitates care transitions from admission through discharge ensuring continuity of care, alignment of services, and post hospital referrals to continuing care agencies. Also serves as a resource for nursing, physicians and ancillary departments on transitional and regulatory issues. The case manager will experience working with culturally diverse patient populations having multiple barriers to self-sufficiency such as: illiteracy, welfare dependency, domestic violence, substance abuse, and mental health issues. The Nurse Case Manager will be responsible for assessment, service planning, resource acquisition, monitoring progress and initiating the responding to emerging client needs. Collaborates with an interdisciplinary team to assess care plans, monitor progress, and make recommendations to ensure safe and efficient hospitalizations. Responsible for evaluating patients in the ED for medical necessity and care coordination needs. Assesses potential admissions and works with advanced practice clinicians/physicians to determine appropriate admission status. Proposes and implements outpatient plans for safe discharge from the ED with physician approval. Coordinates care for patients with abuse, chronic pain, and frequent utilization issues. Interacts with patients or customers of all ages, from newborn to geriatric. As part of this role, they will also interact with individuals who have mental health issues to help them access and navigate the resources they need to improve their well-being. with individuals who have mental health issues to help them access and navigate the resources they need to improve their well-being. Qualifications NECESSARY QUALIFICATIONS Education: Associate’s or Bachelor’s Degree in Nursing Certifications/License: A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment Experience: Three (3) years of clinical nursing experience with (1) year in an Outpatient/Inpatient setting Demonstrated knowledge of the case management, contract health, and utilization review processes 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Effective verbal & written communication skills Team management focus promoting a positive and pro-active approach to problem resolution 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires walking, periods of standing, and sitting. Work also requires extensive periods of time working at a personal computer. Must be able to lift up to 25 lbs (i.e. medical charts); must be able to distinguish numbers, letters, and colors. Mental: Contacts often require tact and sensitivity as those related to stressful situations such as death, dying and catastrophic illnesses. Must be able to prioritize, use good judgment, and coordinate a variety of issues while being frequently interrupted. Responsibilities ESSENTIAL FUNCTIONS Provides comprehensive and client centered service planning and coordination for a specified group of high-risk patients. Manages care of prioritized TCRHCC/SPHC outpatient/inpatient based upon consultation from providers within the TCRHCC/SPHC healthcare delivery system; provides a consistent and on-going consultation with service providers. Works collaboratively with providers and other disciplines to develop and maintain high risk patient database to ensure the continuity of care is established and maintained for the TCRHCC/SPHC outpatient/inpatient population. Works proactively and collaboratively with Utilization Review (UR), Public Health Nursing (PHN), Patient Benefit Coordinators (PBC), and Purchased Referred Care (PRC) at TCRHCC/SPHC. Facilitate communication and coordination between members of the health care team, involving the client in the decision-making process in order to minimize fragmentation in the services (CMSA, 2010). Independently develops and maintains resource databases to ensure timely and accurate information for patient referrals and minimize fragmentation in patient care services. Develops with the patient/family and multidisciplinary team (including service area and/or other non-TCRHCC/SPHC providers as appropriate) a care and service delivery plan based upon the needs identified and available provider and financial resources of the patient and provides consistent and on-going case consultation with all direct service providers. Provides service monitors and follow-up to ensure continuity of care, and updates of the client service plan and provides follow up if needed. Striving to promote client self-advocacy and self-determination (CMSA, 2010). Prepares patient and family for termination (discharge) from case management when services are no longer required. Arranges for any ongoing support/direct care services that the patient will need post-discharge in coordination with discharge planners and other entities such as PHN, Community Health Representatives or Tribal Social Services. Develops reports, performance improvement projects, establishes policy and procedures and program objectives. Will provide Case Management coverage for the Adult Care Unit, Pediatric Unit, Intensive Care Unit, Obstetrics Unit, Emergency Room and Outpatient Departments. Will be familiar with Advance Directives and be a resource person for patients and families; facilitate informed choice, consent, and decision-making. Promote use of evidence-based care, as available, in conjunction with the MCG Care Guidelines. Pursue professional excellence and maintain competence in practice. Serves as the outpatient/inpatient coordinator, such as: The primary contact for outpatient/inpatient in obtaining beds for admissions both within and outside of TCRHCC/SPHC. Collaborate with provider and nursing personnel to ensure admissions are conducted seamlessly and without delay of patient care. Collaborates with provider, nursing personnel and patient benefits coordinators that all admission documentation is complete and all referrals for third party resources are complete prior to the departure of patients. Required to take call on scheduled weekends as deemed necessary. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Performs Other Duties as Assigned.

Urgent Care

1 month ago

Physician Assistant/Nurse Practitioner - Emergency Services

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 serves as a Physician Assistant (PA) or Nurse Practitioner (NP), which involves performance of medical care services for patients of all ages in the Emergency Department. Interviews, assesses, and evaluates patients to determine their physical condition and type of medical services needed, and orders initial diagnostic studies appropriate for the patient’s medical condition. Qualifications NECESSARY QUALIFICATIONS Education: Bachelor’s Degree in Nursing or Physician Assistant studies Experience: At least 2 years’ experience working in emergency department or urgent care setting. Comfort with the treatment and management urgent and emergency conditions from suturing to fracture reduction to sick patient with abdominal pain; sees 4 patients per hour continuously for 12-hour shift in Fast Track setting; and has a good command of ACEP Standards and clinical policies. Licensure/Certification: Must possess a valid, current, full and unrestricted license to practice as a nurse practitioner in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico Must possess a certificate from the NCCPA (National Commission for Certified Physician Assistants) or the American Association of Nurse Practitioners. Credentialing: Must be credentialed and privileged to serve on the Medical Staff 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; has the ability to work effectively in a culturally diverse environment Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Must possess excellent communication and interpersonal skills to optimize the care of patients Excellent clinical skills and judgment Is seen as a staff member who is trustworthy and willing to share information Is a mentor to colleagues and other organizational staff Responds effectively to sensitive inquiries or complaints 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Must have ability of prolonged walking and maintaining balance, ability to frequently stand, bend, kneel, crouch, maintain balance, reach, and occasionally sit, drive, and climb. Frequent ability to lift, push, and pull up to 34lbs is required, must also be able to occasionally lift, push, and pull over 100lbs as needed. Sensory requirements for position include prolonged ability of far, near, color vision, depth perception, seeing fine details, hearing normal speech, hearing overhead pages, and telephone use. Must have both hand manipulation of continuous simple and firm grasping, fine manipulation and frequent use of keyboards. Mental: Must be able to perform evenings, nights, and weekends on a regular basis and handle the stresses of rural medicine with critically ill patients; must have high degree of judgment and leadership in coordinating emergency services. Must have ability to cope with high level of stress, make decisions under high pressure, concentrate, handle a high degree of flexibility handle multiple priorities in stressful situation, work alone, demonstrate high degree of patience, adapt to shift work, work in areas that are close and crowded, and frequently cope with anger/fear/hostility of others in a calm way, as well as occasionally managing altercations. Must accept a flexible schedule to meet unit needs. Environmental: May be exposed to infectious diseases for a prolonged amount of time, frequent exposure to loud noises, and occasional exposure to chemical agents, and hazardous or moving equipment. Responsibilities ESSENTIAL FUNCTIONS Provides comprehensive diagnostic, preventative, and therapeutic health care services to patients. Documents visits in the medical records of patients including updating problem lists. Secures a health and developmental history from the patient or parent, records findings and contributes in making critical evaluations. Performs or requests special screening and developmental tests and laboratory tests and reviews and interprets obvious results. Provides emergency services or crisis intervention in the absence of the physician. Review and evaluates the nursing and medical aspects of care, plans periodically, recognizing when there is a need for reassessment by the physician or other health professionals. Gives direct physical and psychological care in emergencies and in the presence of illness or disability in order to maintain life, provide comfort, reduce distress and enhance coping ability. Identifies and manages a full range of complex to general illnesses. Comfortable handling of basic trauma, suturing, fracture reduction, chest pain & abdominal pain work up. Performs a basic physical assessment using techniques of observation, inspection, auscultation, percussion, palpation and diagnostic instruments. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, and mental problems. Consults and collaborates with other health care professionals to establish health care plans and to review patient progress and response to therapy, including the use of written referrals to Community Health Nurses, specialty clinics, schools, etc. Adheres to medical regimens to stabilize chronically ill persons and adjusts regimens within established protocols. Makes decisions concerning medical care needs of patients consulting with physicians as appropriate. Works collaboratively with the physician in management of selected complex medical problems. Makes referrals for home visits when indicted to implement a care plan based on family needs. Provides health care and preventive services to healthy individuals including immunizations, guidance in nutrition, common illnesses, accidents, child growth and development, substance abuse, exercise, and depression screening. Teaches patients and family member(s) ways to maintain or improve their health status. Carries out treatments and procedures, administers medications; observes and documents changes in patient’s condition, reactions to medications and treatments. Responsible for prescribing medications including computation of doses. Participates in planning, instituting, evaluating, and revision program plan, assist in determining conditions, resources, and policies essential to delivery of health care services. Participates in a teaching capacity in the development of other health care workers. Participates in performance improvement initiatives which may involve chart reviews, studies relevant to health care and nursing needs of patients. Keeps abreast of the latest medical knowledge via CME as required by respective licensing agency. Handwriting must be legible and must be willing to use an Electronic Health Record. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Responsible for electronic health records data entry pertinent to patient service role. Performs other duties as assigned.

New Grad

2 months ago

Physician Assistant/Nurse Practitioner NEW GRAD - Emergency Medical

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 serves as a Physician Assistant (PA) or Nurse Practitioner (NP), which involves performance of medical care services for patients of all ages in the Emergency Department. Interviews, assesses, and evaluates patients to determine their physical condition and type of medical services needed, and orders initial diagnostic studies appropriate for the patient’s medical condition. Qualifications NECESSARY QUALIFICATIONS Education: Master of Science in Nursing or Doctor of Nursing Practice OR Master’s degree in Physician Assistant studies Experience: Nurse Practitione r Must have a minimum of 2 years of Acute Care Nursing (RN) experience. Physician Assistant Completed clinical rotation in a high-acuity Emergency Department under direct supervision of board-certified Emergency Medicine Physicians and PA’s. Licensure/Certification: Must possess a valid, current, full and unrestricted license to practice as a nurse practitioner or Physician Assitant in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico Must possess a certificate from the NCCPA (National Commission for Certified Physician Assistants) or the American Association of Nurse Practitioners. Credentialing: Must be credentialed and privileged to serve on the Medical Staff 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; has the ability to work effectively in a culturally diverse environment Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Must possess excellent communication and interpersonal skills to optimize the care of patients Excellent clinical skills and judgment Is seen as a staff member who is trustworthy and willing to share information Is a mentor to colleagues and other organizational staff Responds effectively to sensitive inquiries or complaints 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Must have ability of prolonged walking and maintaining balance, ability to frequently stand, bend, kneel, crouch, maintain balance, reach, and occasionally sit, drive, and climb. Frequent ability to lift, push, and pull up to 34lbs is required, must also be able to occasionally lift, push, and pull over 100lbs as needed. Sensory requirements for position include prolonged ability of far, near, color vision, depth perception, seeing fine details, hearing normal speech, hearing overhead pages, and telephone use. Must have both hand manipulation of continuous simple and firm grasping, fine manipulation and frequent use of keyboards. Mental: Must be able to perform evenings, nights, and weekends on a regular basis and handle the stresses of rural medicine with critically ill patients; must have high degree of judgment and leadership in coordinating emergency services. Must have ability to cope with high level of stress, make decisions under high pressure, concentrate, handle a high degree of flexibility handle multiple priorities in stressful situation, work alone, demonstrate high degree of patience, adapt to shift work, work in areas that are close and crowded, and frequently cope with anger/fear/hostility of others in a calm way, as well as occasionally managing altercations. Must accept a flexible schedule to meet unit needs. Environmental: May be exposed to infectious diseases for a prolonged amount of time, frequent exposure to loud noises, and occasional exposure to chemical agents, and hazardous or moving equipment. Responsibilities ESSENTIAL FUNCTIONS Provides comprehensive diagnostic, preventative, and therapeutic health care services to patients. Documents visits in the medical records of patients including updating problem lists. Secures a health and developmental history from the patient or parent, records findings and contributes in making critical evaluations. Performs or requests special screening and developmental tests and laboratory tests and reviews and interprets obvious results. Provides emergency services or crisis intervention in the absence of the physician. Review and evaluates the nursing and medical aspects of care, plans periodically, recognizing when there is a need for reassessment by the physician or other health professionals. Gives direct physical and psychological care in emergencies and in the presence of illness or disability in order to maintain life, provide comfort, reduce distress and enhance coping ability. Identifies and manages a full range of complex to general illnesses. Comfortable handling of basic trauma, suturing, fracture reduction, chest pain & abdominal pain work up. Performs a basic physical assessment using techniques of observation, inspection, auscultation, percussion, palpation and diagnostic instruments. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, and mental problems. Consults and collaborates with other health care professionals to establish health care plans and to review patient progress and response to therapy, including the use of written referrals to Community Health Nurses, specialty clinics, schools, etc. Adheres to medical regimens to stabilize chronically ill persons and adjusts regimens within established protocols. Makes decisions concerning medical care needs of patients consulting with physicians as appropriate. Works collaboratively with the physician in management of selected complex medical problems. Makes referrals for home visits when indicted to implement a care plan based on family needs. Provides health care and preventive services to healthy individuals including immunizations, guidance in nutrition, common illnesses, accidents, child growth and development, substance abuse, exercise, and depression screening. Teaches patients and family member(s) ways to maintain or improve their health status. Carries out treatments and procedures, administers medications; observes and documents changes in patient’s condition, reactions to medications and treatments. Responsible for prescribing medications including computation of doses. Participates in planning, instituting, evaluating, and revision program plan, assist in determining conditions, resources, and policies essential to delivery of health care services. Participates in a teaching capacity in the development of other health care workers. Participates in performance improvement initiatives which may involve chart reviews, studies relevant to health care and nursing needs of patients. Keeps abreast of the latest medical knowledge via CME as required by respective licensing agency. Handwriting must be legible and must be willing to use an Electronic Health Record. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Responsible for electronic health records data entry pertinent to patient service role. Performs other duties as assigned.

2 months ago

Nurse Practitioner - Anesthesia

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 The purpose and overall goal of Pre-Anesthesia Screening (PAS) is to gather the clinical information necessary for the safe and effective administration of anesthesia through a process that is convenient for patients and physicians and results in efficient surgical throughput. The Nurse Practitioner of the Pre-Op clinic has overall supervision of the pre-operative clinic provided in the Surgery area, in addition to the flow of the pre-surgical testing and pre anesthesia clearance for patients to gain admittance to the operating room. The Nurse practitioner of the Pre-op clinic will provide input and assist with major decision making processes in regards to cardiac, pulmonary, and overall general health clearance for optimizing the health of patients who will undergo future surgery. They will play a major role in collaboration with the CRNA team and Internal Medicine department to decide if a patient is physically fit to undergo surgery and to decide if the patient’s laboratory markers deem them to be safe candidates for the administration of general anesthesia. Through the development of algorithms and checklists by the CRNA and surgical/Internal medicine team the NP of the Pre-OP clinic will follow these flowsheets to ensure safety of the surgical patient. This pre-op clearance process will allow EKG’s, labs, concerning physical disabilities, medication issues, and allergies to be pre-assessed prior to the day of surgery optimizing patient outcomes and preventing medical errors. The NP of Pre-op clinic will work along with the Chief CRNA to improve overall flow, function, safety and efficiency of the pre-operative and pre-anesthesia processes. Qualifications NECESSARY QUALIFICATIONS Education: Master of Science in Nursing (MSN) – Family Nurse Practitioner (FNP ) Experience: Must have completed a nurse practitioner degree Experience in a pre-op clinic setting preferred Must have active CPR/BLS certification 1-3 years of experience as an RN Mental: Licensure/Certification: Must possess a valid, current, full and unrestricted license to practice as a Nurse Practitioner in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico Must be credentialed to serve on the Medical Staff (provide all related information as requested and needed for credentialing process) 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: The Incumbent must be able to frequently sit, stand, walk, bend, kneel, crouch, twist, maintain balance, and reach. Must be ability to lift, push, pull up to 10 pounds frequently and occasionally help with lifting, pushing, pulling greater than 10 pounds. Must have the ability to frequently utilize sensory requirements of far vision, near vision, depth perception, seeing fine details, and hearing normal speech frequently. Incumbent must also be able to hear overhead pages over a loudspeaker at times. The Incumbent must have the hand manipulation ability to do simple grasping and use of keyboards. The position will require the Incumbent to be exposed frequently to infectious disease, chemical agents, dust, fumes, gases, and hazardous or moving equipment frequently. Occasionally may be exposed to extremes in temperatures or humidity, unprotected heights, and loud noises. Mental: The Incumbent must be autonomous with working alone for prolonged periods of time. Must be able to frequently cope with high level of stress; cope with anger/fear/hostility of others in a calm way; concentrate; handle a high degree of flexibility; handle multiple priorities in stressful situation; demonstrate a high degree of patience; and work in areas that are close and crowded. The Incumbent may frequently need the ability to make decisions under high pressure; manage altercations; and, adapt to shift work. Responsibilities ESSENTIAL FUNCTIONS Serves as Nurse practitioner of the pre-op clinic, incumbent assigns, directs all nurses and staff in the pre-op clinic. Serves under the Chief of CRNA and is directed by the Chief CRNA and all responsibilities. Oversees the day-to-day tasks and activities of pre-op clinic. This includes evaluating ALL patients sent from surgical clinics in a timely fashion to be evaluated and cleared for surgery. This will include a medical history to include allergies and medications, family history of anesthesia complications, physical exam and assessment through algorithms for readiness for surgery. When health or medical concerns arise, the NP will have a dual collaboration with the CRNA present a plan for surgical clearance. Consults to CRNA and IM should be made for all high risk patients. Cardiac clearance and pulmonary clearance may be needed and future testing will ultimately be determined by the CRNA or IM physician. The NP will be responsible for collecting labs and performing the EKG in the pre- op clinic. Supervises the activities of the staff in the pre-op clinic. Ensuring the patients are receiving the appropriate educational information from the pre-op nurse as well as appropriate pre-operative preps to include but not limited to bowel preps, antibiotics, and pre-op at home surgical preps. Provides input and attends meetings for all departments directly affected by pre-operative services. Plans, organizes, coordinates, and directs the operational services of pre-op clinic along with the Chief CRNA, both advise the Chief of Surgical Services, Medical Officer and the Chief Executive Officer of TCRHCC on perioperative matters concerning the pre-anesthesia testing clinic. Participates with members of other departments, in planning joint administrative and technical programs; and making recommendations for maximum coordination of pre-operative services with other patient services. Along with the Chief of Anesthesia, incumbent is also responsible for assuring that TCRHCC meets the requirements of the Joint Commission on Accreditation of Hospitals (JCAHO) with regard to quality of care within the pre-operative anesthesia clinic and assures that hospital policies and procedures are followed. Committee responsibilities include OR committee attendance. Incorporates cultural and developmental needs into plan of care. Provides documentation of patient care in the patient record according to established standards of care. Participates in performance improvement activities which include collecting, analyzing data to identify quantifiable measures to maintain quality and the promotion of desired outcomes. Perform preoperative diagnostic procedures accurately and according to standards, policies, and procedures. Demonstrates competency in performing phlebotomy, obtaining various types of laboratory specimens, electrocardiograms, or other diagnostic tests. Effectively explains perioperative instructions, perioperative treatments, patient care principles, and nursing goals to patient and family/significant others. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Completes all patient care documentation in the electronic health record entries accurately and in real-time. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives Perform other duties as assigned or directed.

Nurse Practitioner/Physician Assistant - Orthopedics - Echo Cliffs - $25K sign On Bonus

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 Under the authority of a supervising orthopedic physician, incumbent provides basic care as a Nurse Practitioner or Physician Assistant for the Orthopedic Department’s ambulatory patients, emergency cases and individuals and families. The position is also designed to identify high priority goals for promotion for health and prevention of disease. Assists with other clinical and administrative activities as required. Qualifications NECESSARY QUALIFICATIONS Education: Master of Science (MS) degree in Nursing or Bachelor’s degree in Physician Assistant Studies License/Certification: Must possess a valid, current, full, and unrestricted license to practice as a Nurse Practitioner or Physician Assistant in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico. Must possess a certificate from the National Commission for Certified Physician Assistants (NCCPA) or must possess a certificate from the American Association of Nurse Practitioners (AANP). Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association Credentialing: Must be credentialed to serve on the Medical Staff (provide all related information as requested for credentialing process). 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 and excellent customer service skills Demonstrated ability in working with people from all levels of discipline Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: The incumbent must have the ability to sit, stand, and walk for prolonged period of the workday, bend, crouch, twist, maintain balance and reach frequently and drive, climb and kneel occasionally. The incumbent must have the ability to lift, push and pull up to 24 lbs. frequently and up to over 100 lbs. occasionally. The incumbent must have the ability for far, near vision, depth perception, hearing norm speech, hearing overhead pages, keyboard, and telephone use for ¾ workday, seeing fine details, simple grasping, firm grasping and fine manipulation frequently and color vision occasionally. The incumbent must accept flexibility to meet units needs ¾ workday. Mental: The incumbent must have the ability to cope with high level of stress , concentrate and work in areas that are close and crowded for prolonged periods of the workday; make decisions under high pressure, cope with anger/fear/hostility of others in a calm way, manage altercations, handle a high degree of flexibility, handle multiple priorities in stressful situations, work alone, demonstrate high degree of patience and adapt to shift work frequently. Environmental: The incumbent may be exposed to infectious disease for prolonged periods of workday, chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous of moving equipment, unprotected heights, and loud noises occasionally. Responsibilities ESSENTIAL FUNCTIONS Functions under the supervision of an orthopedic physician in accordance with established policies and procedures. Interviews, assesses, and evaluates patients of all ages to determine their physical condition and type of medical services needed, and orders initial and post-operative diagnostic studies appropriate for the patient’s medical condition. Accurately records and reports facts, including evaluation and treatment of the whole care of the patient and allows all entries into the patient chart to be reviewed and signed by the supervising physician. Adheres to medical regimens to stabilize chronically ill persons; adjusts regimen within established protocols. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, or mental problems. Consults and collaborates with other health care professionals at Tuba City to established health care plans and to review patient progress and response to therapy, including the use of written referrals to other clinic staff, Community Health Nurses, specialty clinics, schools, etc. Maintains reporting and record systems related to patient care and progress, and as required by TCRHCC and Navajo Area Indian Health Service (NAIHS). Teaches patients and family member’s ways to maintain or improve their health status. Carries out treatments and emergency or other procedures required; administers medication; observes and documents patient conditions, changes and reactions to medications and medical treatment. Supervises orthopedic patients involving the whole management of care requiring the application of principles based upon the biological, physical, and social sciences. Evaluates health care plans and has ability to recognize the need for assessment by the physician and other health professionals. Evaluates total health care needs of patients and develops plans to meet these needs. Administration of joint injections, trigger point injections, punch biopsy, stapling, wound closure and maintenance, casting and splinting, local and digital blocks, suturing, and assess for medication management of chronic and acute disease states. Teaches joint replacement classes and completes health history assessments for surgical procedures. Assists in the surgical suite when accompanied by the surgeon. Works on a regularly assigned, rotational or call back basis to provide continuity of medical services during evenings, nights, holidays, and weekends as needed per interdepartmental agreement. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Completes all patient care documentation in the electronic health record entries accurately and in real-time. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives. Performs other duties as assigned.

Clinical Nurse, Surgery/OR - $10,000 Sign On

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 The Clinical Nurse provides care for the Perioperative Patient. The nursing process includes assessment, formulation of nursing diagnoses, planning interventions, and evaluation of interventions per patient outcomes. The Operating Room clinical nurse is expected to circulate in all specialty areas. These may include Orthopedics, ENT, GYN/OB, General, Ophthalmology, and Dental. Obtaining Scrubbing experience is highly encouraged. May have to work varied, odd hours when on call; and prepare for emergency cases on very short notice. Qualifications NECESSARY QUALIFICATIONS Education: Associate or Bachelor’s Degree in Nursing License/Certification: A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Pediatric Advanced Life Support (PALS) from the American Heart Association within six (6) months of hire National institutes of Health (NIH)-NIHSS-NIH stroke scale must be completed within 6 months of hire Certified Perioperative Nurse (CNOR) by the Competency and Credentialing Institute (CCI) must be completed within 1 year of hire Trauma Nurse core courses (TNCC) within two (2) years of hire Experience: One (1) year clinical nurse with prior operating room practical experience 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; efficient team management skills Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Competency in circulating skills Complete Patient Sitter Competency Training (upon hire) 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Will be working occasionally around fumes or airborne particles; toxic or caustic chemicals; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS Observe, interview, and assess surgery patients during perioperative phase. Initiate treatments, medications, emergency, and resuscitative measures based on evidence-based information, and appropriate utilization of physicians' pre- and post-op orders, standing orders and post anesthesia protocol. Utilize AORN Standards of Care to develop, implement, evaluate nursing plan of care for the peri-operative patient. Demonstrate knowledge and skills in dealing with expectant mother/baby care for C-sections. Record observations, nursing interventions, patient outcomes, and other data relevant to surgical patients. Operate and monitor specialized OR equipment. Operate autoclaves as needed. Monitor patients having surgical procedure under local anesthesia and moderate sedation by assessing cardiopulmonary, and hemodynamic status, level of consciousness and pain levels. Responsible for management of patients undergoing local anesthesia and moderate sedation under the direct supervision of the provider. Collaborate with members of the surgical and multidisciplinary teams in assessing, planning, and implementing surgical intervention in management of patient’s peri-operative health care. Notify Surgeon and/or Anesthesia provider in case of any abnormal diagnostic or physical findings in the patient. Communicate to the patient any ambulation/movement restrictions when applicable. Inform the patient that further education on ambulation/movement restrictions will be performed by Short Stay Surgery staff, or nursing unit RN’s. Functions as team leader and supervises on call team members when called in for emergencies. Monitor supplies and instruments to assure a sterile product is delivered to the sterile field. Correctly labels, handles, and processes all operative specimens. Participate on hospital committees as assigned. Participate in planning and conducting continuing education. Identify, initiate, and participate in nursing studies. Ensure quality patient care despite the situation encountered, be it routine or emergent. Perform scrub duties as necessary. Maintain supplies and monitor outdates. Take OR Call as assigned by immediate supervisor. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction . Performs other duties as assigned.

Surgical Tech

OR Surgical Technician - $3,000 Sign On

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 an established experienced position to obtain Surgical Technologist Certification. This position requires rotational scheduling and on-call (night, weekend, and holiday) coverage. Position requirement includes performing duties of a surgical technologist. Surgical technologists work under the supervision of a surgeon to facilitate the safe and effective conduct of invasive surgical procedures, ensuring that the operating room environment is safe, that equipment functions properly, and that the operative procedure is conducted under conditions that maximize patient safety. Surgical technologists possess expertise in the theory and application of sterile and aseptic technique and combine the knowledge of human anatomy, surgical procedures, and implementation tools and technologies to facilitate a physician's performance of invasive therapeutic and diagnostic procedures. The Technician assists with positioning, surgical prepping, and draping of the surgical patient. Other responsibilities include setting up an operating room before surgery and ensuring all needed equipment and instrumentation is available and in working condition for the scheduled surgical procedure. Surgical specialties include Dental, Endoscopy, General Surgery, Oral & Maxillofacial Surgery, Orthopedic, Otolaryngology/ENT, Ophthalmology, Obstetrics, and Gynecology, Podiatry, Hand, Trauma, Urology, etc. for adult and pediatric patients. Qualifications NECESSARY QUALIFICATIONS Education: High School Diploma or GED Must have completed and provide documentation of at least one of the following: Completion of an approved Surgical Technician training program accredited by the Association of Surgical Technologist (AST) On the Job training in a clinical healthcare setting or military specialty Certification/Licensure: Must be certified within 6 months after 3-year qualification from the National Board of Surgical Technology and Surgical Assisting (NBSTSA 3yr) – or Surgical Technologist Certification (CST), or current certification from National Center for Competency Testing (NCCT-3yr 6240 hours) – Certified Tech in Surgery (TS-C) Must maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Experience: At least nine (9) months of current experience in the specialties of Dental, Endoscopy, General Surgery, Oral & Maxillofacial Surgery, Orthopedic, Otolaryngology/ENT, Ophthalmology, Obstetrics, and Gynecology, Podiatry, Hand, Trauma, Urology, etc. for adult and pediatric patients. 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 of the following areas: Positive working relationships with others Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences or tardies Excellent customer service abilities with effective listening and communication skills Knowledge, ability, and experience to ensure quality patient care during the operative procedure and is constantly on vigil for maintenance of the sterile field and equipment An understanding of the procedure being performed and anticipates the needs of the surgeon 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Physically demanding, high-stress environment; exposure to blood, sharp instruments and other devices, body fluids and tissue, communicable diseases, chemicals, radiation, and repetitive motions. Requires long periods of standing, walking, frequent lifting, bending, and positioning of patients. Requires standing for long periods of time with lead apron for procedures that require radiology support (12 to20 pounds). Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, etc.,, and in moving equipment and medical supplies. Must be able to work in small areas without contaminating him/herself and the surgical team. Must have the manual dexterity to handle and pass surgical instruments without causing injury to self and the surgical team. Must be able to lift a minimum of 50 pounds. Must be able to push/pull mobile equipment weighing up to 300 pounds. Mental: Communication often requires tact and sensitivity, especially when it is related to a stressful situation such as emergencies, death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to multi-task while being frequently interrupted. Concentrate for prolonged periods of time. Communicate in a concise, clear and respectful manner. Must accept a flexible schedule to meet unit needs. Environmental : May continually be exposed to infectious diseases, chemical agents, frequently to extremes in temperature or humidity, hazardous or moving equipment, loud noises and occasional exposure to dust, fumes, gases, and unprotected heights. Responsibilities ESSENTIAL FUNCTIONS Must successfully complete a surgical technologist didactic and clinical training. Completion of all clinical requirements and required exams, must be able to scrub all services, including Dental, Endoscopy, General Surgery, Oral & Maxillofacial Surgery, Orthopedic, Otolaryngology, Ophthalmology, Obstetrics, and Gynecology, Podiatry, Trauma, Urology Utilize Association of Surgical Technologists (AST) Standards of Practice to plan and implement care of the intra-operative patient. Maintain highest standards of sterile technique during procedures. Set up sterile table with instruments, equipment, supplies, and medications/solutions per procedure. Drape the sterile field (back table, mayo stand, OR table, etc.). Perform appropriate counts of sponges, needles, and instruments with circulator prior to the operation and before incision is closed. Scrub daily under registered nurse supervision for different advanced and complex types of surgeries. Scrub, gown, and glove for surgical procedures and gown and glove the surgeons and assistants. Ensure all necessary equipment is in good working order. Pass instruments, etc. to the surgeon during procedure. Prepare sterile dressings Clinical duties include the provision of patient care and support of individuals of all ages and their families. Accept and appropriately label all medications/solutions needed for surgical procedures per policy. Assist in terminal cleaning and preparing room for the next patient. Take initiative in reporting equipment in need of repairs and low levels of supplies. Take apart and reassemble any instrument or piece of equipment that needs attention and prepare instruments for terminal sterilization. Correct breaks in aseptic techniques by any person to provide optimum patient care. Monitor, inventory assigned service supplies and order as needed. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Perform other duties as assigned.

CNM

Per Diem

Nurse Midwife, PER DIEM

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 Full scope group nurse-midwifery practice – gynecology (including contraception and menopause), antepartum, intrapartum, post-partum, initial newborn. Rotating schedule between clinic and the hospital. Collaborates with obstetrician/gynecologists and other providers, co-manages and/or refers as appropriate. Admits patients. Performs complete history and physical examinations on adults, teens, and newborns. Determines dosage and timing of medications, orders and/or administers medications. Utilizes fetal monitoring equipment including application of fetal scalp electrodes, IUPCs, and/or amnioinfusion, and interprets the meaning of the information recorded. Determines the content, orders and/or administers intravenous solutions and medications and performs other specialized procedures. First-Assistant in Cesarean Sections. Performs limited ultrasound. Represents midwives and/or the OB Department on various hospital committees. Accepts responsibility for departmental administrative projects. Performs other functions generally accepted as typical of a Certified Nurse-Midwife, as requested. Night-shift rotation on the Labor & Delivery Unit is an essential part of this position. Qualifications NECESSARY QUALIFICATIONS Education: A Bachelor of Science degree from an accredited school of nursing License/Certification: Certified Nurse-Midwives must be Registered Nurses, hold current certification by the American Midwifery Certification Board (AMCB) and must have graduated from a nurse-midwifery education program accredited by the ACNM Accreditation for Midwifery Education (ACME). Must possess and maintain a valid, current, full and unrestricted license to practice as a nurse in any state within the United States, District of Columbia or the Commonwealth of Puerto Rico. Certified Nurse-Midwives must be certificated by the American College of Nurse-Midwives (ACNM) or the American Midwifery Certification Board (AMCB) (formerly known as ACNM Certification Council, Inc.) and have graduated from a post-baccalaureate midwifery education program which is accredited by the ACNM Division of Accreditation. A Master's degree with a major in Midwifery or Public Health is strongly recommended. Experience: Will accept new graduates with a minimum of 2 years of experience in Labor and Delivery as a Registered Nurse Credentialing: Must be credentialed and privileged to serve on the TCRHCC Medical Staff 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: Must be proficient with basic computer skills, including word-processing and e-mail. Positive working relationships with others Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences. 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: The work requires prolonged standing, walking, maintaining balance, frequent sitting, bending, climbing, kneeling, crouching, twisting, and reaching. Must have ability of prolonged lifting, pushing, and pulling of patients up to 50lbs. Sensory requirements for position include prolonged ability of color vision, depth perception, seeing fine details, hearing normal speech, hearing overhead pages, and telephone use. Must have ability of both hand manipulation in prolonged simple and firm grasping, fine manipulation, and use of keyboards. Round-the-clock coverage of patient care may cause physical and emotional stress unique to the role. Mental: Must be able to perform well in crisis situations. Must be able to work well within a group. Must have prolonged ability of coping with high levels of stress, making decisions under high pressure, coping with anger/fear/hostility of others in a calm way, concentrating, handling high degree of flexibility, handling multiple priorities in stressful situation, working alone, demonstrating high degree of patience, adapting to shift work, and working in areas that are close and crowded. Environmental : May be exposed to infection diseases and loud noises for a prolonged period of time, and occasional exposure to chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous or moving equipment, and unprotected heights. Responsibilities Essential Functions Conducts spontaneous vaginal delivery without the use of forceps or vacuum. Determines methods and administers anesthesia such as local blocks , and arranges intrathecal analgesia and epidural anesthesia as indicated. Performs episiotomy and does repair of episiotomy and/or lacerations, records the delivery in permanent record book or computer , and signs the completed birth certificate. Determines the need for ultrasound, non-stress tests, oxytocin challenge tests, interprets the results of the tests, and uses the results to plan and carry out a course of treatment. Manages the care of patients during the postpartum period. Provides family planning education/services, and gynecological services, to women (including teens). Assumes responsibility for the triage of common health problems presented by women (including teens) and for management, collaboration, co-management and/or referral to appropriate levels of health care services. Prescribes the full range of contraception including, but not limited to, birth control pills, emergency contraception/ “morning-after pills,” inserts intrauterine contraceptive devices and contraceptive implants, fit s diaphragms, does pelvic examinations and Pap tests . Treats hemorrhage and shock. Collaborates in planning, and participates in, educational programs for patients, family, staff and community. Must be able to work a rotating full-time schedule, including nights and weekends. Must be able to perform well in crisis situation. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Completes all patient care documentation in the electronic health record entries accurately and in real-time. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives Performs other duties as assigned.

Nurse Practitioner, Mental Health Counselor, Echo Cliffs - $25K Sign On Bonus

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 The incumbent will provide therapeutic mental health services to individuals, families, and groups. Treatment and assessment techniques will need to encompass a broad range of mental health concerns; including, but not limited to depression, mania, anxiety disorders, PTSD, psychosis, substance abuse, and suicidality. The incumbent will develop and implement therapeutic treatment plans in the clinical setting as well as conducting educational workshops and participating in outreach programs. Qualifications NECESSARY QUALIFICATIONS Education: Master’s Degree (M.A.) in areas of Psychology, Social Work, Counseling, Marriage and Family Therapy or related mental health field. Certification: Must be a licensed professional practicing in the field of Mental Health licensed by the Arizona Board of Behavioral Health Examiner’s or other states that allow transfer of credentialing to Arizona Experience: Completion of supervision hours required for independent licensure (typically 50-100 hours depending on the specific degree and state) 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 of the following areas: Positive working relationships with others Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences. Thorough knowledge of the psychological disorders as defined in the Diagnostic and Statistical Manual of the Mental Disorders (DSM-V). Ability to use computers and navigate the electronic medical record Able to respond appropriately in stressful situations Able to provide direct patient care in a kind, patient, and compassionate manner TCRHCC that the applicant can perform the essential functions of the job 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Must be able to sit at a desk for long periods of time. Some physical exertion such as long hours of standing and walking is required. Must have ability of prolonged driving. Sensory requirements for position include prolonged ability of near vision, seeing fine details, hearing normal speech, hearing overhead pages, and telephone use. Must have ability of continued use of keyboards. Mental: Child/Family Mental Health Psychiatric Nurse Practitioner must possess and demonstrate a broad knowledge of mental health treatment, functions and activities, effectively integrating mental health treatments with medical and community health activities. Must be able to prioritize and use good judgment. Incumbent must be able to coordinate a variety of issues while being frequently interrupted. Must have ability to continually cope with high level of stress, make decisions under high pressure, cope with anger/fear/hostility of others in a calm way, manage altercations, concentrate, handle a high degree of flexibility, handle multiple priorities in stressful situations, work alone, demonstrate high degree of patience, and work in areas that are close and crowded. Must be able to occasionally adapt to shift work and continually accept a flexible schedule to meet unit needs. Environmental : May continually be exposed to infectious diseases. Responsibilities ESSENTIAL FUNCTIONS Provides diagnostic, treatment, and referral services for psychiatric patients. Conducts individual, family, and group psychotherapy using evidence-based modalities Coordinates services to patients with psychiatrist and other mental health personnel. Conducts intakes and administers diagnostic tests (if applicable) in order to identify behavioral and personality traits and documents results. Plans and administers therapeutic treatment such as behavior modification, social skills, anger management and stress management therapy to assist patients in controlling disorders and other problems. Provides crisis intervention services to clients with a wide variety of acute mental health problems, including suicide attempts, family conflicts, alcohol misuse, drug abuse, grief reactions, and trauma resulting from violence. Provides follow-up on patients who have recently been discharged from inpatient psychiatric facility and those with poor adherence to treatment plan. Maintains all appropriate client records according to professional and departmental policies. On-call coverage is provided on a schedule coordinated with the emergency room. Takes rotation along with rest of staff. Works closely with the Navajo Tribal Division of Social Services, law enforcement and other agencies to coordinate services for mental health patients who have serious family and other social problems. Refers patients to supportive services to supplement treatment and counseling when needed. Responsible for electronic health records data entry pertinent to patient service role. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering face piece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction Performs other duties as assigned.

Psych

Nurse Practitioner. Psychiatry, Echo Cliffs

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 responsible for overseeing the psychological service needs of individuals, families, groups, and the community at large. Also entails conducting formal and informal assessments, conducting clinical interviews, and developing treatment plans for patients with complex mental or emotional problems. Duties may include facilitating groups, conducting educational workshops, and participating in outreach programs. Candidate must adhere to evidence-based practice guidelines, professional standards, and Tribal, State, and Federal legal requirements. Work schedule consists of taking call on an assigned, rotating schedule that includes weekdays, weekends, nights and holidays. Qualifications NECESSARY QUALIFICATIONS Education: Must have Masters’ degree in Psychiatric Mental Health Licensure: Must have a valid, current and unrestricted license to practice as a Psychiatric Mental Health Nurse Practitioner in any state within the United States, District of Columbia or the Commonwealth of Puerto Rico. Must maintain continuous valid license with documentation of continuing education credits submitted to the State Board of Nursing; must adhere to the professional, ethical, and legal guidelines outlined by the individual’s licensing body. Experience: Completion of education and supervision hours required for independent licensure. 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 Possession of high ethical standards and no history of ethical violations Reliable and dependable; reports to work as scheduled without excessive absences Thorough knowledge of the psychological disorders as defined in the Diagnostic and Statistical Manual of the Mental Disorders (DSM-V). Ability to use computers and navigate the electronic medical record Able to respond appropriately in stressful situations Able to provide direct patient care in a kind, patient, and compassionate manner 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Must be able to sit at a desk for long periods of time. Some physical exertion such as long hours of standing and walking is required. Must have ability of prolonged driving. Sensory requirements for position include prolonged ability of near vision, seeing fine details, hearing normal speech, hearing overhead pages, and telephone use. Must have ability of continued use of keyboards. Mental: Child/Family Mental Health Psychiatric Nurse Practitioner must possess and demonstrate a broad knowledge of mental health treatment, functions and activities, effectively integrating mental health treatments with medical and community health activities. Must be able to prioritize and use good judgment. Incumbent must be able to coordinate a variety of issues while being frequently interrupted. Must have ability to continually cope with high level of stress, make decisions under high pressure, cope with anger/fear/hostility of others in a calm way, manage altercations, concentrate, handle a high degree of flexibility, handle multiple priorities in stressful situations, work alone, demonstrate high degree of patience, and work in areas that are close and crowded. Must be able to occasionally adapt to shift work and continually accept a flexible schedule to meet unit needs. Environmental : May continually be exposed to infectious diseases. Responsibilities ESSENTIAL FUNCTIONS Depending on the credentials of the incumbent: Provides diagnostic, treatment, and referral services for psychiatric patients using evidence-based practices. Develops treatment plans including type, frequency, intensity, and duration of therapy in collaboration with the treatment team. Evaluates effectiveness of treatment, and modifies plan as needed. Makes appropriate psychotherapy referrals when indicated. Collaborates with all members of the mental health team. Provides clinical supervision. Directs, coordinates, and evaluates activities for non-licensed staff and student interns engaged in patient evaluation and treatment. Provides crisis intervention services to clients with a wide variety of acute mental health problems, including suicide attempts, family conflicts, alcohol misuse, drug abuse, grief reactions, and trauma resulting from violence. Provides follow-up on patients who have recently been discharged from inpatient psychiatric facility and those with poor adherence to treatment plan. Maintains all appropriate client records according to professional and departmental policies. On-call coverage is provided on a schedule coordinated with the emergency room. Takes rotation along with rest of staff. Works closely with the Navajo Tribal Division of Social Services, law enforcement and other agencies to coordinate services for mental health patients who have serious family and other social problems. Refers patients to supportive services to supplement treatment and counseling when needed. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction. Performs other duties as assigned.

Nurse Practitioner, Family Medicine, Echo Cliffs - $25K Sign On Bonus

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 Serves as nurse practitioner at the Tuba City Regional Health Care Corporation, Tuba City, Arizona, which involves performance of medical care services for patients in the Family Medicine outpatient clinic. Qualifications NECESSARY QUALIFICATIONS Education: Master of Science in Nursing or Doctor of Nursing Practice Licensure/Certification: Must possess a valid, current, full, and unrestricted license to practice as a nurse practitioner in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico Certification by the American Association of Nurse Practitioners Experience: Must have a minimum of 2 years of clinical experience as a Nurse Practitioner. Credentialing: Must meet additional requirements for credentialing and privileging for membership to the Medical Staff 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 Ability to work effectively in a culturally diverse environment Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Must possess excellent communication and interpersonal skills to optimize the care of patients Excellent clinical skills and judgment Is seen as a staff member who is trustworthy Is a mentor to colleagues and other organizational staff Responds effectively to sensitive inquiries or complaints 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Must be able to frequently walk several hundred yards quickly, sit, stand, and reach, occasionally bend and kneel. Must also be able to write well, hear well (for cardiac examinations) and see well for complete diagnostic skills. Sensory requirements are near vision, hearing normal speech, telephone use, frequent depth perception, hearing overhead pages and occasional far vision, color vision and seeing fine details. Mental: Interaction with emotionally disturbed patients is common. Must be able to work evenings on a regular basis and handle the stresses of rural medicine. Must be able to continuously cope with high level of stress, make decisions under high pressure, concentrate, handle high degree of flexibility, demonstrate high degree of patience, adapt to shift work, frequently cope with anger, fear, hostility of others in a calm way, handle multiple priorities in stressful situation and occasionally work alone and work in areas that are close and crowded. Environmental: Work is performed in a clinic setting where exposure to infectious disease is common May have frequent exposure to chemical agents, occasional exposure to dust, fumes, gases, extremes in temperature or humidity, and loud noises. Responsibilities ESSENTIAL FUNCTIONS Provides comprehensive diagnostic, preventative, and therapeutic health care services to adult patients. Direct Patient Care Services Interviews, assesses, and evaluates patients to determine their physical condition and type of medical services needed, and orders initial diagnostic studies appropriate for the patient’s medical condition. Performs a basic physical assessment using techniques of observation, inspection, auscultation, percussion, palpation and use of diagnostic instruments. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, and mental problems. Consults and collaborates with other health care professionals at Tuba City to establish health care plans and to review patient progress and response to therapy, including the use of written referrals to Community Health Nurses, specialty clinics, etc. Adheres to medical regimens to stabilize chronically ill persons and adjusts regimens as clinically appropriate. Documents visits in the Electronic Medical Record of patients including updating problem lists, medications, etc. Makes decisions concerning medical care needs of patients consulting with physicians as appropriate. Works collaboratively with physicians in the management of complex medical problems as appropriate. Provides health care and preventive services to healthy individuals including immunizations, guidance in nutrition, common illnesses, accidents, substance abuse, exercise, and depression screening. Educates patients and family members in ways to maintain or improve their health status. Carries out treatments and procedures as required. Observes and documents changes in patient’s condition, reactions to medications and treatments. Responsible for prescribing medications including computation of doses. Performs other duties as assigned. Administrative Tasks Participates in planning, instituting, evaluating, and revising program plans, assists in determining conditions, resources, and policies essential to delivery of health care services. Participates in performance improvement initiatives which may involve chart reviews. Keeps abreast of the latest medical knowledge via CME as required by respective licensing agency. Participates in hospital committees as assigned by supervisor. Participates in a teaching capacity in the development of other health care workers. Is responsible for electronic health records data entry pertinent to patient care. Provider may be assigned to work in clinics in different locations than their main assignment based on the needs of the organization i.e. Tuba City, Sacred Peaks, LeChee, Mobile Van, Bodaway Gap etc. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Completes all patient care documentation in the electronic health record entries accurately and in real-time. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives Performs other duties as assigned.

Pediatric

Clinical Nurse, Pediatric Acute - $10K Sign on

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 The Clinical Nurse performs a variety of nursing care procedures requiring professional knowledge and consideration for specific patient conditions and treatments, and ability to work independently in completing assignments. Guidelines include physician’s orders, standards of care, nursing policies and procedures manuals, hospital policies. Nursing duties include support to individuals of all ages and their families. Qualifications NECESSARY QUALIFICATIONS Education: Associate’s or Bachelor’s Degree in Nursing License/Certification: A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Pediatric Advanced Life Support (PALS) from the American Heart Association Complete Pediatric Trauma Care After Resuscitation (P-CAR) within 6 months of hire National Institutes of Health (NIH) – NIHSS – NIH Stroke Scale must be completed (within 6 months of hire) Patient Sitter Competency up on hire Experience: A minimum of one (1) year clinical nursing experience providing direct patient care to infants, children, and adults. 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Knowledge of normal growth, development and life cycle changes. This also includes knowledge of the physical, psychosocial and behavioral characteristics of the group for which care is provided. Knowledge of disease entities in order to recognize complications and therapeutic interventions required. Knowledge of assessment practices related to pain management and various treatment modalities of pain relief. Knowledge of pharmaceuticals in order to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications. Knowledge of infection control procedures and safety precautions. Possesses and employs an ability to communicate with patients and families during time of emotional and physical stress Complete Patient Sitter Competency Training (upon hire) 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, application, 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Will be working occasionally around fumes or airborne particles; toxic or caustic chemicals; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS: Responsible for providing direct observation of patients as directed by the nursing plan of care and under the supervision of the nursing staff and/or nursing department supervisor. Responsible for assisting nursing staff to create, maintain and provide a safe environment. Develops individualized patient care plans and periodic evaluation of plans to ensure that intended results are being achieved. Provides counseling and teaching to patients and families or surrogates on preventive, curative and rehabilitative measures involved in health care. Interviews patients and family members and consults with attending physicians, other staff members to determine and evaluate the kind of health and physical care needed. Carries out treatments and procedures per scope of practice. Maintains health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient and timely manner. Maintains professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serving on nursing committees. Recognize adverse signs and symptoms, which are not always apparent and to react promptly in emergency situations including the implementation of life saving procedures. Participates in the development, implementation and evaluation of standards of care, Quality Assurance and Infection Control activities. Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Monitor and initiate corrective action to maintain the environment of care including equipment and material resources. Delegate tasks and supervise the activities of other licensed and unlicensed care providers as appropriate in accordance with licensure standards. Performs phlebotomy, intravenous cannulation, administers IV medications Acts as charge nurse for a group of patients or an entire unit when assigned. When assigned as team leader, provides guidance, direction and training to ancillary nursing and other personnel. Floats to other departments as required. Participates in orientating new employees. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (Refer to the CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction. Performs other duties as assigned.

ICU

Clinical Nurse, ICU - Rotational Shifts - $10K Sign on

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 The Intensive Care Unit (ICU) Clinical provides professional nursing care for acutely and critically ill patients in accordance with physician orders and established policies procedures, and philosophy. The ICU clinical nurse provides nursing services in a highly technical and ongoing monitoring environment. The ICU nurse provides nursing care to the patient, family and significant others accordance with the scope of a Registered Nurse (RN) as defined by the Arizona State Board of Nursing. Qualifications NECESSARY QUALIFICATIONS Education: Associate Degree in Nursing Certifications: Must have and maintain a current valid unrestricted Professional Nursing License (RN) to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must maintain current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Pediatric Advanced Life Support (PALS) from the American Heart Association must be completed within six (6) months of hire. Trauma Care After Resuscitation (TCAR) must be completed within 6 months of hire National Institutes of Health (NIH) – NIHSS – NIH Stroke Scale must be completed within 6 months of hire Experience: Must have one (1) year critical care nursing experience or two (2) years of Nursing Experience in Adult Med/Surg Must have a successful completion of a Critical Care program within last 12 months, if none, prior Critical Care experience is required 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Knowledge of normal growth, development and life cycle changes. This also includes knowledge of the physical, psychosocial and behavioral characteristics of the group for which care is provided Knowledge of disease entities to recognize complications and therapeutic interventions required Knowledge of assessment practices related to pain management and various treatment modalities of pain relief Knowledge of pharmaceuticals to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications Knowledge of infection control procedures and safety precautions Complete Patient Sitter Competency Training (upon hire) 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, application, 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Will be working occasionally around fumes or airborne particles; toxic or caustic chemicals; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS ICU nurse provides direct and individualized nursing care to acutely and critically ill patients based on the application of scientific and evidenced based nursing principles. Model exemplary interpersonal communication, leadership, critical thinking and decision-making. In addition to general nursing care, responsibilities of the ICU clinical nurse include: Responsible for providing direct observation of patients as directed by the nursing plan of care and under the supervision of the nursing staff and/or nursing department supervisor. Responsible for assisting nursing staff to create, maintain and provide a safe environment. Develop individualized patient care plans and participates in patient care planning which involves the assessment and evaluation of patient needs, periodic evaluation of plans to ensure that intended results are being achieved. Interview patients and family members; consult and coordinate with providers and other members of the health care team to assess, plan, implement, and evaluate patient care plans carries out treatments and procedures per scope of practice. Provide counseling and education to patients and families or surrogates on preventive, curative and rehabilitative measures related to their health care needs. Serve as patient advocate by supporting the basic rights, values, and beliefs of the patient. Maintain health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient, and timely manner, in the appropriate format and appropriate forms. Maintain a high level of expertise in critical care and proficiency in changing techniques and standards of practice in critical care nursing through continuing education, staff meetings, workshops and serving on nursing committees. Will attain knowledge and complete hospital accreditation standards and other regulatory requirements. Participate in the identification of clinical or operational performance improvement (PI) opportunities and in PI activities. Recognize adverse signs and symptoms, which are not always apparent, and to respond promptly in emergency situations including the implementation of life saving procedures. Participate in the development, implementation, and evaluation of standards of care, Quality Assurance, and Infection Control activities. Contribute to positive working relationships within the ICU team and other departments in the hospital. Monitor and initiate corrective action to maintain the environment of care including equipment and material resources. Monitors and adjusts specialized equipment used on patients, and interprets and records electronic displays, such as pulmonary artery pressures, and cardiac rhythms from cardiac monitors, ventilators, etc. Delegate tasks and supervise the activities of other licensed and unlicensed care providers as appropriate in accordance with licensure standards. Accept responsibility delegated by the Supervisory Clinical Nurse or designee, when assigned as team leader, providing guidance, direction and training to ancillary nursing and other personnel. Serve as charge nurse for a group of patients or an entire unit when assigned. Float to other units as needed. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, and eye or face shield as required. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates). Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Perform other duties as assigned.

Clinical Nurse, ACU - Night Shift - $10k Sign on

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 The Clinical Nurse performs a variety of nursing care procedures requiring professional knowledge and consideration of specific patient conditions and treatments, and ability to work independently in completing assignments. Guidelines include physician’s orders, standards of care, nursing policies and procedures manuals, hospital policies. Nursing duties include support to individuals of all ages and their families. Qualifications NECESSARY QUALIFICATIONS Education: Associate or Bachelor Degree in Nursing Experience One-year clinical experience working as a nurse in an acute or sub-acute facility. License and Certification A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must have and maintain current valid certifications of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Complete Patient Sitter Competency Training (Upon Hire) Complete Trauma Care After Resuscitation - TCAR within six months of hire National Institutes of Health (NIH) – NIHSS – NIH Stroke Scale must be completed within 6 months of hire 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Knowledge of normal growth, development, and life cycle changes. This also includes knowledge of the physical, psychosocial and behavioral characteristics of the group for which care is provided. Knowledge of disease entities to recognize complications and therapeutic interventions required. Knowledge of assessment practices related to pain management and various treatment modalities of pain relief. Knowledge of pharmaceuticals to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications. Knowledge of infection control procedures and safety precautions. Possesses and employs an ability to communicate with patients and families during time of emotional and physical stress Successful completion of and positive results form 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, application, 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs. frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both feet; and, hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Required to work prolong periods of time in an environment of toxic or caustic chemicals. May work and be exposed frequently to Infection Diseases. Will be working occasionally around other environmental conditions including: Chemical Agents; Dust, Fumes, Gases; Extremes in Temperature or Humidity; Hazardous or Moving Equipment; Unprotected Heights; loud noises; risk of radiation; vibration; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS: Responsible for providing direct observation of patients as directed by the nursing plan of care and under the supervision of the nursing staff and/or nursing department supervisor. Responsible for assisting nursing staff to create, maintain and provide a safe environment. Develop individualized patient care plans and periodic evaluation of plans to ensure that intended results are being achieved. Interview patients and family members and consults with attending physicians, other staff members to determine and evaluate the kind of health and physical care needed. Carry out treatments and procedures per scope of practice. Maintain health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient and timely manner. Participate in orientating new employees. Maintain professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serving on nursing committees. Provide counseling and teaching to patients and families or surrogates on preventive, curative and rehabilitative measures involved in health care. Recognize adverse signs and symptoms, which are not always apparent and to react promptly in emergency situations including the implementation of life saving procedures. Participate in the development, implementation and evaluation of standards of care, Quality Assurance and Infection Control activities. Monitor and initiate corrective action to maintain the environment of care including equipment and material resources. Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Delegate tasks and supervise the activities of other licensed and unlicensed care providers as appropriate in accordance with licensure standards. Perform phlebotomy, intravenous cannulation, administers IV medications. Float to other clinics as required. Act as charge nurse for a group of patients or an entire unit when assigned. When assigned as team leader, provides guidance, direction and training to ancillary nursing and other personnel. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (Refer to the CDC website for most current updates). Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction Perform other duties as assigned.

Clinical Nurse, ACU - Day Shift - $10k Sign on

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 The Clinical Nurse performs a variety of nursing care procedures requiring professional knowledge and consideration of specific patient conditions and treatments, and ability to work independently in completing assignments. Guidelines include physician’s orders, standards of care, nursing policies and procedures manuals, hospital policies. Nursing duties include support to individuals of all ages and their families. Qualifications NECESSARY QUALIFICATIONS Education: Associate or Bachelor Degree in Nursing Experience One-year clinical experience working as a nurse in an acute or sub-acute facility. License and Certification A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must have and maintain current valid certifications of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Complete Patient Sitter Competency Training (Upon Hire) Complete Trauma Care After Resuscitation - TCAR within six months of hire National Institutes of Health (NIH) – NIHSS – NIH Stroke Scale must be completed within 6 months of hire 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Knowledge of normal growth, development, and life cycle changes. This also includes knowledge of the physical, psychosocial and behavioral characteristics of the group for which care is provided. Knowledge of disease entities to recognize complications and therapeutic interventions required. Knowledge of assessment practices related to pain management and various treatment modalities of pain relief. Knowledge of pharmaceuticals to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications. Knowledge of infection control procedures and safety precautions. Possesses and employs an ability to communicate with patients and families during time of emotional and physical stress Successful completion of and positive results form 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, application, 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs. frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both feet; and, hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Required to work prolong periods of time in an environment of toxic or caustic chemicals. May work and be exposed frequently to Infection Diseases. Will be working occasionally around other environmental conditions including: Chemical Agents; Dust, Fumes, Gases; Extremes in Temperature or Humidity; Hazardous or Moving Equipment; Unprotected Heights; loud noises; risk of radiation; vibration; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS: Responsible for providing direct observation of patients as directed by the nursing plan of care and under the supervision of the nursing staff and/or nursing department supervisor. Responsible for assisting nursing staff to create, maintain and provide a safe environment. Develop individualized patient care plans and periodic evaluation of plans to ensure that intended results are being achieved. Interview patients and family members and consults with attending physicians, other staff members to determine and evaluate the kind of health and physical care needed. Carry out treatments and procedures per scope of practice. Maintain health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient and timely manner. Participate in orientating new employees. Maintain professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serving on nursing committees. Provide counseling and teaching to patients and families or surrogates on preventive, curative and rehabilitative measures involved in health care. Recognize adverse signs and symptoms, which are not always apparent and to react promptly in emergency situations including the implementation of life saving procedures. Participate in the development, implementation and evaluation of standards of care, Quality Assurance and Infection Control activities. Monitor and initiate corrective action to maintain the environment of care including equipment and material resources. Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Delegate tasks and supervise the activities of other licensed and unlicensed care providers as appropriate in accordance with licensure standards. Perform phlebotomy, intravenous cannulation, administers IV medications. Float to other clinics as required. Act as charge nurse for a group of patients or an entire unit when assigned. When assigned as team leader, provides guidance, direction and training to ancillary nursing and other personnel. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (Refer to the CDC website for most current updates). Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction Perform other duties as assigned.

OB/GYN

Clinical Nurse, OB/GYN - Rotational Shift - $10K Sign on

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 The Obstetric Clinical Nurse performs a variety of nursing care procedures requiring professional knowledge and consideration of specific patient conditions and treatments, and ability to work independently in completing assignments. Assists physicians and midwives during examinations and procedures. Provides comprehensive, family centered nursing care to mothers and babies during antepartum, intrapartum and postpartum periods. Guidelines include physician’s orders, standards of care, nursing policies and procedures manuals, hospital policies. Nursing duties include support to individuals of all ages and their families. Qualifications NECESSARY QUALIFICATIONS Education: Associate or Bachelor Degree in Nursing License/Certification: Must have a valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Must maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Neonatal Resuscitation Program (NRP) from the American Heart Association AWHONN Intermediate EFM Certification required within six (6) months of hire AWHONN Advanced EFM Certification required within six (6) months of hire. National Institutes of Health (NIH) – NIHSS – NIH Stroke Scale required within six (6) months of hire STABLE Certification within 1 year of hire Advanced Life Support in Obstetrics (ALSO) within 1 year of hire Experience: A minimum of at least one (1) year of OB nursing experience in antepartum, intrapartum, postpartum, nursery and Labor and Delivery. 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 Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences Knowledge of normal growth, development and life cycle changes. This also includes knowledge of the physical, psychosocial and behavioral characteristics of the group for which care is provided Knowledge of disease entities in order to recognize complications and therapeutic interventions required Knowledge of assessment practices related to pain management and various treatment modalities of pain relief Knowledge of pharmaceuticals in order to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications Knowledge of infection control procedures and safety precautions Complete Patient Sitter Competency Training (upon hire) 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, application, 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift up to 50 lbs frequently through entire shift. Most be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Will be working occasionally around fumes or airborne particles; toxic or caustic chemicals; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS Develop individualized patient care plans and periodic evaluation of plans to ensure that intended results are being achieved. Interview patients and family members and consults with attending physicians, CNM, other staff members to determine and evaluate the kind of health and physical care needed. Carry out treatments and procedures per scope of practice. When assigned as team leader, provides guidance, direction and training to ancillary nursing and other personnel. Maintain health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient and timely manner. Maintain professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serving on nursing committees. Provide counseling and teaching to patients and families or surrogates on preventative, curative and rehabilitative measures involved in health care. Knowledge of normal growth, development and life cycle changes. This also includes knowledge of the physical, psychosocial and behavioral characteristics of the group for which care is provided. Knowledge of assessment practices related to pain management and various treatment modalities of pain relief. Knowledge of pharmaceuticals to organize the desired effects, side effects and complications on their use. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (Refer to the CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction. Perform other duties as assigned.

7 months ago

Nurse Practitioner/Physician Assistant - Orthopedics

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 Under the authority of a supervising orthopedic physician, incumbent provides basic care as a Nurse Practitioner or Physician Assistant for the Orthopedic Department’s ambulatory patients, emergency cases and individuals and families. The position is also designed to identify high priority goals for promotion for health and prevention of disease. Assists with other clinical and administrative activities as required. Qualifications NECESSARY QUALIFICATIONS Education: Master of Science (MS) degree in Nursing or Bachelor’s degree in Physician Assistant Studies License/Certification: Must possess a valid, current, full, and unrestricted license to practice as a Nurse Practitioner or Physician Assistant in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico. Must possess a certificate from the National Commission for Certified Physician Assistants (NCCPA) or must possess a certificate from the American Association of Nurse Practitioners (AANP). Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association Credentialing: Must be credentialed to serve on the Medical Staff (provide all related information as requested for credentialing process). 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 and excellent customer service skills Demonstrated ability in working with people from all levels of discipline Possession of high ethical standards and no history of complaints Reliable and dependable; reports to work as scheduled without excessive absences 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: The incumbent must have the ability to sit, stand, and walk for prolonged period of the workday, bend, crouch, twist, maintain balance and reach frequently and drive, climb and kneel occasionally. The incumbent must have the ability to lift, push and pull up to 24 lbs. frequently and up to over 100 lbs. occasionally. The incumbent must have the ability for far, near vision, depth perception, hearing norm speech, hearing overhead pages, keyboard, and telephone use for ¾ workday, seeing fine details, simple grasping, firm grasping and fine manipulation frequently and color vision occasionally. The incumbent must accept flexibility to meet units needs ¾ workday. Mental: The incumbent must have the ability to cope with high level of stress , concentrate and work in areas that are close and crowded for prolonged periods of the workday; make decisions under high pressure, cope with anger/fear/hostility of others in a calm way, manage altercations, handle a high degree of flexibility, handle multiple priorities in stressful situations, work alone, demonstrate high degree of patience and adapt to shift work frequently. Environmental: The incumbent may be exposed to infectious disease for prolonged periods of workday, chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous of moving equipment, unprotected heights, and loud noises occasionally. Responsibilities ESSENTIAL FUNCTIONS Functions under the supervision of an orthopedic physician in accordance with established policies and procedures. Interviews, assesses, and evaluates patients of all ages to determine their physical condition and type of medical services needed, and orders initial and post-operative diagnostic studies appropriate for the patient’s medical condition. Accurately records and reports facts, including evaluation and treatment of the whole care of the patient and allows all entries into the patient chart to be reviewed and signed by the supervising physician. Adheres to medical regimens to stabilize chronically ill persons; adjusts regimen within established protocols. Discriminates between normal and abnormal findings to recognize early stages of serious physical, emotional, or mental problems. Consults and collaborates with other health care professionals at Tuba City to established health care plans and to review patient progress and response to therapy, including the use of written referrals to other clinic staff, Community Health Nurses, specialty clinics, schools, etc. Maintains reporting and record systems related to patient care and progress, and as required by TCRHCC and Navajo Area Indian Health Service (NAIHS). Teaches patients and family member’s ways to maintain or improve their health status. Carries out treatments and emergency or other procedures required; administers medication; observes and documents patient conditions, changes and reactions to medications and medical treatment. Supervises orthopedic patients involving the whole management of care requiring the application of principles based upon the biological, physical, and social sciences. Evaluates health care plans and has ability to recognize the need for assessment by the physician and other health professionals. Evaluates total health care needs of patients and develops plans to meet these needs. Administration of joint injections, trigger point injections, punch biopsy, stapling, wound closure and maintenance, casting and splinting, local and digital blocks, suturing, and assess for medication management of chronic and acute disease states. Teaches joint replacement classes and completes health history assessments for surgical procedures. Assists in the surgical suite when accompanied by the surgeon. Works on a regularly assigned, rotational or call back basis to provide continuity of medical services during evenings, nights, holidays, and weekends as needed per interdepartmental agreement. Responsible for electronic health records data entry pertinent to patient service role. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Completes all patient care documentation in the electronic health record entries accurately and in real-time. Participates in departmental workflow and or testing teams as related to electronic health record or other project initiatives. Performs other duties as assigned.

9 months ago

RD/ Diabetes Case Manager - (DH1621)

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 responsible for providing inpatient and outpatient medical nutrition therapy appropriate to medical diagnoses; providing diabetes self-management education; and using public health approaches to prevent and treat obesity, diabetes, and complications of diabetes. Provides case management services for a sub-population of patients with diabetes, e.g. newly-diagnosed, patients who are pregnant, diabetes in youth, uncontrolled T2DM, etc. These services promote efficient and effective use of a variety of health resources by focusing on the whole patient to provide a seamless continuum of care. The goals are the provision of quality health care, decreased fragmentation of care, enhancement of a patient’s self-care and quality of life and cost containment. Incumbent also participates in weekend/holiday rotating on-call schedule to provide medical nutrition therapy for inpatients, with and without diabetes. Qualifications NECESSARY QUALIFICATIONS Education: Must have Bachelor’s Degree in Dietetics or for graduates 2023 and after must have a Master’s Degree in Nutrition, Public Health or related field. Experience: Must have a minimum of 6 months experience as a clinical dietitian in an inpatient or outpatient setting with experience in diabetes self-management. Certification: Must be a current Registered Dietitian in good standing with the Commission on Dietetic Registration (CDR) Must have a registered RD licensure from any state, if none, must obtain within (1) one monthof hire. Must have and maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association 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 an 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 & 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 Incumbent must be able to sit at a desk for long periods of time, write legibly and use a computer terminal. The position requires the ability to frequently stand and walk. Other general physical abilities include the ability to occasionally bend, kneel, crouch, twist, maintain balance and reach. Incumbent has the sensory ability for hearing normal speech, hearing overhead page on loud speaker, talk over the telephone and in person with others. This position requires sensory ability for frequent use of far vision, near vision, and seeing fine details. It also requires occasional sensory ability for color vision and depth perception. The expectation is the position may occasionally lift, push and pull up to 24lbs. Incumbent will need to have the hand manipulation ability with prolonged use of keyboard; occasionally need for simple grasping, fine manipulation, and firm grasping. MENTAL Incumbent must be able to prioritize and use good judgment; coordinate a variety of issues while being frequently interrupted; assess data such as lab values and weights. This position requires the mental and emotional prolonged ability to handle a degree of flexibility and demonstrate high degree of patience. The incumbent will frequent need the ability to concentrate, handle multiple priorities in a stressful situation, work alone, and work in areas that are close and crowded. Incumbent must be able to occasionally accept flexible schedules to meet unit needs. ENVIRONMENTAL Incumbent may occasionally be exposed to infectious diseases, chemical agents, dust, fumes, gases, extremes in temperature or humidity, hazardous or moving equipment . Responsibilities ESSENTIAL FUNCTIONS Provides inpatient and outpatient medical nutrition therapy and diabetes self-management education. Performs individual patient needs assessment to evaluate intervention priorities. Assesses patient needs, medical condition, lab values, nutrition and weight status, 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. Provides diabetes self-management education in both individual and group settings utilizing the IHS “Balancing Your Life with Diabetes” and Association of Diabetes Care & Education Specialist (ADCES) curricula, using ADCES-7 framework. Apply 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. Utilize a case management model to follow a specific sub-population of diabetes patients, e.g. newly diagnosed, adolescents, pregnant patients, high-risk patients, etc. Ensure patients receive recommended services and appropriate follow-up. Provides consultant services to the TCRHCC Dietary Department as needed, such as tray-line monitoring, menu updates, and in-service training. Provides inpatient medical nutrition therapy to patients with and without diabetes on a rotating weekend/holiday on-call schedule. Maintains current licensure, job-related competencies, and knowledge of evidence-based guidelines through active participation in continuing education, independent study, seminars, in-services, and dialogue with colleagues. Ensure proper PPE is worn at all times while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee, and external customer satisfaction. Performs other duties as assigned.

9 months ago

Clinical Nurse - Emergency Services

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 The Clinical Nurse performs a variety of nursing care procedures requiring professional knowledge and consideration for specific patient conditions and treatments, and ability to work independently in completing assignments. Guidelines include physician’s orders, standards of care, nursing policies and procedures manuals, hospital policies. Nursing duties include support to individuals of all ages and their families. Qualifications NECESSARY QUALIFICATIONS Education: Associate of Science Degree in Nursing or Bachelor of Science Degree in Nursing License/Certification : A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States. Must maintain a current valid certification of the following throughout employment: Basic Life Support (BLS) from the American Heart Association Advanced Cardiac Life Support (ACLS) from the American Heart Association Pediatric Advanced Life Support (PALS) from the American Heart Association Neonatal Resuscitation Program (NRP) required within one (1) year of hire from American Heart Association Trauma Nurse Core Course (TNCC) required within one (1) year of hire Emergency Nurse Pediatric Course (ENPC) required within one (1) year of hire National Institutes of Health (NIH) – NIHSS – NIH Stroke Scale must be completed (within 6 months of hire) Emergency Severity Index Level 5 within 3 months of hire Complete Patient Sitter Competency Training (upon hire) Experience: Must have one (1) year registered nursing experience in an emergency department or critical care unit. 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 Possession of high ethical standards and no history of complaints Reliable and dependable; report to work as scheduled Knowledge of normal growth, development, and life cycle changes. This also includes knowledge of the physical, psychosocial, and behavioral characteristics of the group for which care is provided. Knowledge of disease entities to recognize complications and therapeutic interventions required. Knowledge of assessment practices related to pain management and various treatment modalities of pain relief. Knowledge of pharmaceuticals to recognize the desired effects, side effects and complications on their use, with emphasis on vasopressors and emergency medications titration of these medications. Knowledge of infection control procedures and safety precautions. Possess and employ an ability to communicate with patients and families during time of emotional and physical stress Successful completion of and positive results form 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, application, 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 employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical: Work requires prolonged periods of standing; walking; talking or hearing; sitting watching, observing, concentrating on computer monitors and equipment; use of hands to finger, handle, feel; bending, stooping, kneeling, crouching; reaching with hands and arms; and, taste or smell. Agility and the ability to lift, pull and bend are required to move patients to and from beds, wheelchairs, stretchers, et cetera, and in moving equipment and medical supplies. Must be able to lift to 50 lbs. frequently through entire shift. Must be able to move, pull/push, lift, maneuver more than 100 lbs. when caring for patients and must be able to use proper body mechanics and lifting equipment when available. Must be able to discern when working with over a hundred pounds when, how, and who to ask for assistance to protect and prevent self-injury. Must have the ability to hear and recognize alarms on equipment; client calls; instructions from physicians/department staff; and, hear overhead pages through loudspeaker. This position requires vision required to see close; distant; colored; peripheral; and depth perception. Must be able to adjust visual focus as needed. to ask for assistance. This position requires the ability to perform repetitive motion actions in both feet; and, hands including prolonged grasping of simple/light action; intermittent grasping of firm/heavy action; and prolonged ability of fine dexterity. Mental: Contacts often require tact and sensitivity as those related to stressful situation such as death, dying, and catastrophic illnesses. Must be able to prioritize and use good judgment. Must be able to coordinate a variety of issues while being frequently interrupted. Must be able to work with the attitude of team building with other staff; collaborate with multiple departments and job positions. Must be willing to assist when able and as needed with other team players. Environmental: Required to work prolong periods of time in an environment of toxic or caustic chemicals. Will be working occasionally around the following environmental conditions: wet, humid conditions (non-weather); work near moving mechanical parts; toxic or caustic chemicals; outdoor weather condition; extreme cold (non-weather); extreme heat (non-weather); risk of electrical shock; risk of radiation; vibration; and, risk of electric shock. Typical environmental noise level is moderate. As with any area of a Health care setting, must be able to work around and with infectious diseases. Responsibilities ESSENTIAL FUNCTIONS: Responsible for providing direct observation of patients as directed by the nursing plan of care and under the supervision of the nursing staff and/or nursing department supervisor. Responsible for assisting nursing staff to create, maintain and provide a safe environment Develop individualized patient care plans and periodic evaluation of plans to ensure that intended results are being achieved. Interview patients and family members and consults with attending physicians, other staff members to determine and evaluate the kind of health and physical care needed. Recognize adverse signs and symptoms, which are not always apparent and to react promptly in emergency situations including the implementation of life saving procedures. Carry out treatments and procedures per scope of practice. Maintains health records by documenting observations, nursing interventions and therapeutic measures administered in an accurate, efficient, and timely manner. Provide counseling and teaching to patients and families or surrogates on preventive, curative and rehabilitative measures involved in health care. Make every effort to have positive working relationships with the ER staff and contribute to teamwork within the department. Monitor and initiate corrective action to maintain the environment of care including equipment and material resources Maintain professional knowledge and proficiency in nursing through continuing education, staff meetings, workshops and serve on nursing committees, as requested. Understand and adhere to established compliance and quality assurance standards. Participate in the development, implementation and evaluation of standards of care, Quality Assurance and Infection Control activities/projects. Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Delegate tasks and supervise the activities of other licensed and unlicensed care providers as appropriate in accordance with licensure standards, when assigned as team leader; and provide guidance, direction and training to ancillary nursing and other personnel. Act as charge nurse for a group of patients or an entire unit when assigned. Responsible for electronic health records data entry pertinent to patient service role. Float to other units are needed. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates) Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction Perform other duties as assigned.

Oncology

Part-time

10 months ago

Nurse Practitioner (0.50 FTE) - Oncology