The department of Infectious Diseases is seeking a Clinical Nurse Case Manager to provide nursing assessments, TB/HIV/STD education, and coordination of care for TB/HIV/STD patients. Additionally, the Clinical Nurse Case Manager will provide medical case management services to patients and contacts served at Baltimore City Health Department (BCHD) STD/HIV/TB clinics.
Specific Duties & Responsibilities
Provide all duties of nurse case management for active TB cases and contacts
Gather all relevant clinical data on active TB patients from hospitals, nursing homes, and other sources. This data includes, but is not limited to, all microbiologic data (including non-TB labs), all laboratory data, discharge summaries, and radiologic reports
Conducts initial nursing evaluation of new referrals within 72 hours, including hospital or home visits if needed. Initial nursing evaluation includes assessment of clinical history and labs, social and housing situation, insurance status, and assessment of infection control needs. For new cases of TB being initiated on TB therapy, the nurse case-manager should administer D.O.T. when possible during the period of home isolation.
Serve as the point-person to coordinate clinical care for all assigned active TB patients. This includes coordination of care with patient’s medical team including primary care physician, hospital physicians, social workers, and other ancillary staff. The case-manager is responsible for executing the medical treatment and monitoring plan as developed by ECC clinicians or clinicians designated by ECC to direct clinical care.
Ensure that all routine monitoring of active TB patients is carried out, with results communicated to ECC clinicians in a timely fashion. The case-manager is responsible for updating clinicians during medical meeting about clinical events, due dates for routine LFT’s, CXR, and sputums.
The case-manager is responsible for performing an in-person evaluations of the patient at least monthly during the course of treatment
The case-manager shall perform and document a monthly case-summary, and will ensure that all monitoring benchmark labs (LFT’s, HIV testing, CXR, and sputum smears and cultures) are performed and documented in a timely fashion.
Ensure that patient is following through with Directly Observed Therapy (DOT) and monitor treatment progress (including documentation of weekly dose counts). When adherence issues arise, develop strategy for improved adherence, including initiation of Commissioner’s Order when needed. For patients that are missing, make reasonable efforts at finding the patient, including home visit, contacting local hospitals/shelters/DOC, etc. Some patients may utilize video-based DOT or alternative strategies to monitor adherence. The nurse case manager will perform monitoring of video-based DOT no less frequently than once per week, and preferrably on the same day as expected doses.
Conducts TB contact investigations in the field. The case-manager is responsible for initiating evaluation of TB suspects. Initial evaluation includes gathering of all relevant clinical data, performing a home/hospital visit within 1 week of referral, and establishing parameters for infection control.
The case-manager is responsible for identifying high and medium risk contacts of active pulmonary TB cases, completing testing, and ensuring treatment or window prophylaxis when indicated. 90% of smear-positive cases should have contact investigation testing completed within 15 business days.
Ensure that TB contacts who are diagnosed with latent TB are prescribed appropriate treatment either by ECC or private providers, and monitor completion of therapy.
Complete documentation of all contact investigations, clinical summaries, case-manager evaluations, communication with patient and providers. Ensure that all relevant data is entered accurately into ECC database.
Conducts nursing assessments for active TB cases, TB suspects, individuals with latent TB, and contacts of TB cases, and facilitates engagement in care.
Assists in evaluation and follow-up of immigrants and refugees with abnormal chest radiographs read overseas as consistent with TB upon the migrant’s arrival to the Baltimore area.
Assists with public health reporting of notifiable diseases, and coordinate public health activities between BCHD and Maryland Department of Health and Mental Hygiene and Centers for Disease Control and Prevention (CDC). Compiles and provides data for regional cohort reviews.
Coordinates interjurisdictional transfers of TB patients or contacts, when indicated.
Coordinates TB infection control practices with patients, providers, and hospitals
Dispenses TB medications, according to standing orders and the BCHD RN dispensing formulary.
Coordinates treatment for TB patients, and provides directly observed therapy of TB treatment in the field when indicated
Provides education on STD/HIV/TB to patients, contacts, and health care providers
Assist with clinic initiatives as necessary.
Other duties as assigned
Individual must be a registered nurse, licensed in the State of Maryland or state where practicing. Bachelor's degree in nursing or related discipline preferred. Current CPR certification required. Must maintain current licensure and certification during duration of employment. Acceptable completion of the JHH credentialing process is required prior to start date.
Special Knowledge, Skills, and Abilities
Knowledge and interest in STD/HIV/TB disease and treatment. Knowledge and interest in public health aspects of infectious disease control. Ability to work with culturally diverse patients, staff and community populations. Ability to work in multidisciplinary, multi-organizational team setting.
Strong organizational skills with attention to detail and follow-through. Self-starter with the ability to work with minimal supervision. Phlebotomy skills. Proficiency in medical and conversational Spanish is preferred. Reliable transportation.
Classified Title: Clinical Nurse Case Manager Working Title: CO Clinical Nurse Case Manager Role/Level/Range: ACRP/03/ME Starting Salary Range: $59,159 -$81,406, Commensurate with experience Employee group: Full Time Schedule: Monday-Friday, 8:30am -5:00pm, Up to 37.5 hours per week, with the potential for extended hours Exempt Status: Exempt Location: 04-MD:School of Medicine Campus Department name: 60000455-SOM DOM ID BCHD Personnel area: School of Medicine
The successful candidate(s) for this position will be subject to a pre-employment background check.
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During the Influenza ("the flu") season, as a condition of employment, The Johns Hopkins Institutions require all employees who provide ongoing services to patients or work in patient care or clinical care areas to have an annual influenza vaccination or possess an approved medical or religious exception. Failure to meet this requirement may result in termination of employment.
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