Fresenius Medical Care North America Holdings Limited Partnership jobs in Fayetteville, NC

**Possible hybrid opportunity available!** **PURPOSE AND SCOPE:** Provides nutritional services for the facility's in-center and home patients as applicable in order to maximize the patient's nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) activities. Actively participates in process improvement activities that enhance the likelihood that patients will achieve their individualized patient-specific goals as determined by the patient's physician. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Assesses patient's knowledge of diet and kidney disease and provides education appropriate to patient's learning needs regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides patient specific detailed education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process. + Completes nutritional assessment and participates in the interdisciplinary comprehensive assessments. + Participates with the interdisciplinary team in the development of a written, individualized comprehensive plan of care that specifies the services necessary to address the patient's needs, in accordance with established Federal and, where applicable, state licensure guidelines. + Calculates diet prescription according to standard of practice. + Completes progress notes on all chronic dialysis patients according to established FMCNA guidelines. Maintains complete and accurate documentation of all appropriate information in medical record according to established FMCNA policies and Federal and state regulations. + Provides patient with ongoing nutrition assessment and outcome-oriented nutrition counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished patients as well as patients at risk for malnutrition and works collaboratively with interdisciplinary team to identify appropriate interventions, resources or solutions. Reviews each patient's albumin level and body weight at least monthly. Implements plan of care with involvement of patient/family/caregiver. + Monitors adherence and response to nutrition therapy, adjusts therapy as needed to achieve and sustain an effective nutritional status, documents why the patient was unable to achieve the goals and implements the plan of care to address issues impacting the patient's ability to achieve the goals. + Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician's prescription of Kt/V. + Collaborates with the interdisciplinary team on management and recommendations for mineral metabolism and renal bone disease, anemia and iron status, nutritional status, psychosocial status, vascular access, modality, rehabilitation status and sodium/volume control. + Adheres to FMCNA algorithm and medical record policies. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Collaborates and coordinates with team members in provision of Pre-ESRD education as appropriate. + When appropriate, works with Case Manager to coordinate plan of care for patient education and identifies candidates to refer to physician for nutritional supplements, as per disease management agreements. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Communicates with physician and/or facility staff regarding lab results as appropriate. + Communicates lab results and recommended treatment changes to providers of patient care in nursing facilities (i.e., hospitals, short term and long-term care facilities). + Participates in pertinent staff meetings (i.e., general staff, quality improvement), Care plan meetings, and others as applicable. + Consults with FMS Corporate Dietitian regarding nutrition concerns as needed. + Maintains and improves knowledge and skills for a competent and innovative practice. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. + Collaborates with interdisciplinary team, ensuring that all work areas are safe and clean. + Other nutrition management duties as assigned. + Performs other related duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS** **:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. + The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS** **:** + Registered Dietitian as per Commission on Dietetic Registration + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS** **:** + Minimum of 1-year professional work experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. + Demonstrated leadership competencies and skills for the position, including ability to teach, strong organizational skills, excellent communication, customer service, relationship development, results orientation, team building and decision making. + Able to perform responsibilities with minimum supervision. + Basic computer skills required. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PRINCIPAL DUTIES AND RESPONSIBILITIES:** - Aligns with regional, group, and corporate, business-related goals through all activities and actions. - Adheres to standards and scope of nursing practice, company policy, procedures, compliance, regulatory, legal, and ethical, requirements. - Focuses all programs towards achieving a culture of patient safety, clinical quality goals, and improving patient outcomes, using company and industry guidelines and standards. - Develops competency and skills to educate personnel in all chronic kidney disease treatment programs. - Empowers and promotes a culture of lifelong learning through professional programs, coaching, and available technologies. - Collaborates with relevant partners at all levels to schedule, provide, and implement education programs, technologies, and processes for new and current personnel. - Utilizes appropriate educational venues and generational learning techniques to deliver, support, and evaluate training. - Partners in the implementation of action plans through to resolution, as appropriate. - Uses facilitation techniques and the variety of tools and resources available to promote immersive, engaging, learning experiences. - Develops and maintains open, effective, and timely communication with internal and external customers such as company management and facility team, government agencies, physicians, hospitals, and contracted travel personnel. - Demonstrates leadership competencies, excellent communication, customer service, continuous quality improvement, relationship development, critical thinking, team building, motivating employees, performance management, and decision- making skills. - Supports metric / KPI programs, with timely and complete data documentation, reporting, and ongoing quality improvement processes. - Maintains knowledge of products, services, and strategies to support and train staff appropriately in all modalities. - Trains new employees with demonstration and oversight of direct patient care-related activities. - Perform other related duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** - The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - Day to day work includes desk and personal computer work and interaction with patients, Regional and facility/program employees, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, departmental, and corporate meetings may be required. - The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases / materials. - This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines, and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. - May be asked to provide essential functions of this position in other locations which may include overnight stays, with the same physical demands and working conditions as described above. - This position requires between 35-90% travel **SUPERVISION:** - None **EDUCATION AND REQUIRED SKILLS:** - Associate or Bachelor's degree from an accredited School of Nursing. - Advanced degree BSN or MSN (preferred) - Current appropriate RN state licensure in primary state of residence - Obtain and maintain RN state licensure in assigned states as directed - Must meet the practice requirements in the state of employment - Minimum 1-year dialysis experience as a Registered Nurse - CDN or CNN (preferred) or must attain within 18 months of employment - Successful completion and maintenance of CPR BLS (Basic Life Safety) Certification, all annual and ongoing required education / training / competencies. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. **Education/Communication:** + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. PRINCIPAL DUTIES AND RESPONSIBILITIES: All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. · Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. · Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. · Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. · Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. · Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. · Initiates or assists with emergency response measures. · Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. · Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. · Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. · Ensures patient awareness related to transplant and treatment modality options. · Required to complete CAP requirements to advance. · Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. · This position requires frequent, prolonged periods of standing and the employee must be able to bend over. · The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. · The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. · May be exposed to infectious and contagious diseases/materials. · Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. · The position may require travel to training sites or other facilities. · May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. SUPERVISION: Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: · Successful completion of all FKC education and training requirements for new employees. · Must have a minimum of 9 months experience as a RN. · Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. EDUCATION and LICENSURE: · Graduate of an accredited School of Nursing. · Current appropriate state licensure. · Current or successful completion of CPR BLS Certification. · Must meet the practice requirements in the state in which he or she is employed. EXPERIENCE AND REQUIRED SKILLS: · Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. · Chronic/acute hemodialysis experience (preferred). **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** Supports FMCNA's mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory requirements and programs. Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of care and patient and staff safety **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Manages the tactical execution of short- and long-term objectives through the coordination of activities with a direct responsibility for results, including costs, methods, and staffing. + Provides leadership, coaching and development plans for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters. + Technically proficient in the specific department and knowledge of industry practice and business principles. Works on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends. Has a larger range within the department. + Responsible for supporting and driving FMS quality standards through meeting all ESRD regulatory requirements and the practice of Quality Assessment and Improvement (QAI), including use of FMS QAI tools. + Responsible for addressing and acting on adverse events and action thresholds. + Oversees facility's Home Therapies Program if applicable. + Accountable for compliance with all applicable federal, state and local laws and regulations. + Ensures all FMS Clinical Quality policies and procedures are communicated to and implemented by the facility staff. + Maintains integrity of medical records and other FMS administrative and operational records. + Complies with all data collections and auditing activities. + Maintains facility environmental integrity, including safety. + Experienced leadership required for multi-faceted environment; role primarily focuses on tactical execution. Receives assignments in the form of objectives and determines how to use resources to meet schedules and goals. + An individual contributor will have significant project/process responsibilities. Program or project responsibility generally within the function. + Follows processes and operational policies in selecting methods and techniques for obtaining solutions. Interprets and recommends change to policies and establishes procedures that effect immediate organization(s). + Decisions have an impact on work processes and outcomes. Erroneous decisions or failure to achieve results will add costs and may impact the short-term goals of the organization. + Frequently interacts with subordinate supervisors, customers, and/or functional peer group managers, normally involving matters between functional areas, other company divisions or units, or customers. + Participates and presents at meetings with internal and external representatives. Often leading a cooperative effort among members of a project team. + Interacts with internal departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. + Responsible for hiring, coaching and counseling employees, including performance reviews, disciplinary action and terminations. + Provides technical guidance. + Performs other related duties as assigned. **PATIENT CARE:** + Coordinates all aspects of patient care with the appropriate staff members, from admission through discharge of the patient. + Ensure education of the patient regarding quality measures, transplant options, modality awareness, and access care, including catheter reduction and adherence to treatment regime. + Acts as a resource for the patient to address patient concerns and questions. + Accountable for timely completion of patient care assessments and care plans by organizing meetings of the facility's Interdisciplinary Team to discuss patient care plans and to resolve patient problems. + Directs initiation, maintenance and communication of efficient and timely patient schedules to ensure maximization of the facility station efficiency. + Is aware of and develops a mechanism or process for knowing the specific situation of each patient, including hospitalizations, no- shows, catheter use, and any significant change in patient care status. + Develops action plans for unexcused and missed treatments in collaboration with the Director. + Plans, coordinates and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely workup of patients for access management, dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination of care with the multidisciplinary renal team. Communicates changes in patient status regarding clinical, insurance, travel and transportation issues to the disease management company. Maintains current knowledge of disease management software and systems as pertinent. **STAFF:** + Responsible for implementation of FMS staffing, and medical supply models, to provide quality patient care, and makes recommendations. + Participates in the recruitment and interview process, and decision to hire new personnel. + Ensures completion of new hiring orientation and training including mandatory in-services and ICD code training when applicable. Ensures documentation completed for annual in service training, and policy and procedure in service updates. + Responsible for all patient care employees receiving appropriate training according to FMS policy, including training to ensure ongoing compliance with all FMS risk management initiatives. + Provides opportunities for professional growth, and training to ensure clinical competence and the ability for licensed staff to assume Team Leader responsibilities + Responsible for overseeing performance of all licensed personnel, direct patient care staff, reporting indirect patient care personnel as assigned, and when necessary, technical staff. Provides employee education and guidance, and feedback related to performance. + Maintains current knowledge regarding FMCNA benefits, Human Resources policies, procedures, and processes, and acts as a resource to facility staff. + Provides counseling for all clinical staff members at regular intervals offering support and encouraging professional growth. + Completes timely employee evaluations and establishes annual goals for staff. + Provides written documentation of all disciplinary conferences in accordance with the established personnel policies, and confers with the Director and Human Resources regarding the nature of the disciplinary decisions. + Participates in Corporate and Business Unit specific employee recognition and satisfaction programs. + Creates, maintains, and communicates efficient and timely employee schedules according to the needs of the facility. + Creates and implements a Continuous Quality Improvement (CQI) Process Improvement Team that involves staff in problem solving. **PHYSICIANS:** + Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + Responsible for strong Director and physician relationships and facilitating staff relationships with physicians. + Ensures regular and effective communication with all physicians, through regular meetings with Directors. + Participates in Governing Body. + Schedules and coordinates CQI meetings with physicians. **MAINTENANCE/TECHNICAL:** + Responsible for the integrity and safety of the facility water system. + Must be knowledgeable in the operation of all facility equipment and technology. **ADMINISTRATIVE:** + Responsible for maintaining and updating all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, and responds as appropriate. + Directs information gathering as required supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve supply cost goals following all guidelines established in FMS formularies + Participates in the completion and interpretation of the Pl-17 inventory supply use analysis. + Reviews and approves facility payroll. + Reviews profit and loss statements with Director + Responsible for participating in all required Network reporting and on-site state or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians + Position may require travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **SUPERVISION:** + Responsible for the direct supervision of various levels of staff as designated by region. **EDUCATION AND REQUIRED CREDENTIALS:** + Bachelor's Degree; Advanced Degree desirable or an equivalent combination of education and experience + Graduate of an accredited School of Nursing (RN). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + 6 - 8 years' related experience or an equivalent combination of education and experience. + 3+ years' supervisory or project/program management experience preferred. + Minimum of 12 months experience in clinical nursing is required. Experience in med/surg or ICU/CCU is preferred. + Minimum of 6 months chronic or acute dialysis nursing experience is required. + Must be available as a full-time employee and provide on-call coverage when necessary. + Demonstrated leadership competencies and skills for the position, including excellent communication, customer service, continuous quality improvement, relationship development, results orientation, team building, motivating employees, performance management, and decision making. + Demonstrated management skills necessary to provide leadership in the supervision of dialysis personnel and to ensure the delivery of maximum quality care to all patients. + Must complete Clinical Manager training modules and ongoing developmental programs within the specified time line. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. **Education/Communication:** + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**RN-Clinical** **About this role:** As a Dialysis Clinic Registered Nurse (RN) with Fresenius Medical Care, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease. Our clinic RNs build strong bonds and lasting relationships with people who entrust us with their care, their families, and fellow care team members. **How you grow or advance:** As a Dialysis RN, you will enter our Clinical Advancement Program (CAP) to grow and advance in your career. By participating in CAP, you will develop clinical leadership skills, derive greater career satisfaction, have an opportunity to share your expertise with others, and be recognized for your experience, knowledge, and clinical expertise. All new hires will begin at the appropriate CAP level based on prior experience and education. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state, and federal regulations. + As a member of the nephrology health care team, you will participate in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. + Coordinates patient care including assessment, planning, intervention, and evaluation for an assigned group of hemodialysis patients. This includes delegation of appropriate tasks to direct patient care staff. + Performs ongoing analysis of patient data with each patient visit and documents in the patient medical record. + Adjusts or modify the treatment plan as indicated and notify supervisor as needed. + Provides initial and ongoing education to patient and family. + Administers medications as prescribed or in accordance with approved algorithm(s), and document appropriate medical justification and effectiveness. + Initiates or assist with emergency response measures. + Ensures correct laboratory collection, processing, and shipping procedures are performed. + Collaborates with the Interdisciplinary Team on the patient care plan. + Ensures patient awareness related to transplant and treatment modality options. + Completes CAP requirements to either maintain or advance within the program. + Makes referrals to Social Worker and Registered Dietitian as appropriate. + Ensures patient awareness related to transplant and treatment modality options. **EDUCATION AND LICENSURE:** + Graduate of an accredited School of Nursing. + Current appropriate state licensure. + Current or successful completion of CPR BLS Certification. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND SKILLS:** + Qualities and traits: compassion, caring, support for colleagues, collaborative, reliable. + Experience as a Registered Nurse (preferred but not required). + Chronic/acute hemodialysis experience (preferred but not required). + Successfully pass the Ishihara Color Blind Test. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. + This position requires frequent, prolonged periods of standing and the employee must be able to bend over. + The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. + May be exposed to infectious and contagious diseases/materials. + Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. + The position may require travel to training sites or other facilities. + May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** " **EOE, disability/veterans**

**About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning for our managers. The curriculum will cover onboarding, essential functions, leading your business, and advanced leadership. As a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL RESPONSIBILITIES AND DUTIES** CLINIC OPERATIONS: + Manages the operations of the clinic, including costs, processes, staffing, and quality standards. + Provides leadership, coaching, and development plans for all direct reports. + Partners with internal Human Resources, Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies Program. + Maintains integrity of medical and operations records and complies with all data collections and auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + Responsible for all required network reporting and on-site state or federal surveys. PATIENT CARE: + Coordinates all aspects of patient care with the appropriate staff members, from admission through discharge of the patient. + Ensure education of the patient regarding quality measures, transplant options, modality awareness, and access care. + Acts as a resource for the patient and family to address concerns and questions. + Accountable for timely completion of patient care assessments and care plans. + Manages timely patient schedules to ensure facility efficiency and develops action plans for missed treatments. + Plans, coordinates, and validates patient eligibility for treatment. + Reports changes in patient status regarding any clinical, insurance, or travel and transportation issues. STAFF: + Participates in the selection and hiring of new team members and ensures completion of new hiring orientation and mandatory trainings. + Responsible for all patient care employees completing appropriate training courses and that licensures/certifications are current. + Provides support for all clinical staff members at regular intervals and encourages professional growth. + Maintains current knowledge regarding company benefits, policies, procedures, and processes. + Completes employee evaluations and establishes annual goals. + Documents any disciplinary actions and confers with the clinic Director of Operations and Human Resources when needed. + Manages staff scheduling and payroll. PHYSICIANS: + Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical Staff By-Laws. + Responsible for strong physician relationships and ensures regular and effective communication. + Participates in Governing Body, an interdisciplinary team for each region including MSWs, Dietitians, MDs, DOs etc. that governs policies. **EDUCATION AND REQUIRED CREDENTIALS:** + Bachelor's Degree or an equivalent combination of education and experience. + Graduate of an accredited School of Nursing (RN). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+ years business operations experience in a healthcare facility. + 12 months experience in clinical nursing. + 6 months chronic or acute dialysis nursing experience. + Successfully pass the Ishihara Color Blind Test. + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + Day-to-day work includes desk and personal computer work and interaction with patients, facility staff, and physicians + Position may require travel between assigned facilities and various locations within the community and/or travel to regional, business unit, and corporate meetings may be required. + The work environment is characteristic of a healthcare facility with air temperature control and moderate noise levels. + May be exposed to infectious and contagious diseases/materials. + Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting, moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**P** **ossible hybrid opportunity available!** May hire dietitians with less than 1 year of clinical experience. Benefits as a RD for Fresenius: + Competitive salary + Extensive training with senior leadership and in-field RDs + Continuous support + Key player as IDT member (MDs look to you as the Subject Matter Expert) + Autonomy + Working at the top of our license + Career progression **About this role:** As a Dietitian with Fresenius Medical Care, you will be a valuable member of the interdisciplinary team and a part of a close-knit, collaborative team responsible for delivering unique nutritional care to patients facing end stage renal disease. Our RDs build strong bonds and lasting relationships with patients, their families, and all team members. **How you grow or advance:** We offer a Core Curriculum program, which includes CEUs, specifically for dietitians on all the topics of renal nutrition therapy. Our orientation and training program is designed to develop experts in the field of renal nutrition, allowing you to work at the top of your license. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL RESPONSIBILITIES AND DUTIES:** + Assesses patient's knowledge and provides education regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process. + Completes nutritional assessment and works with the interdisciplinary team to develop an individualized comprehensive plan of care for patients. + Maintains complete and accurate medical records including progress notes. + Provides ongoing assessment and counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished or at-risk patients and works collaboratively with the interdisciplinary team to identify appropriate interventions, resources, or solutions. + Monitors, adjusts, and documents response to nutrition therapy and addresses any issues impacting the patient's ability to achieve the goals. + Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician's prescription of Kt/V. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Identifies candidates to refer to physician for nutritional supplements. + Communicates with physician and/or facility staff as appropriate. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. **EDUCATION:** + Registered Dietitian as per Commission on Dietetic Registration. + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS:** + 1+ year experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. **Education/Communication:** + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention, and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs, and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state, and federal regulations. + Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. + Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. + Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. + Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. + Initiates or assists with emergency response measures. + Serves as a resource, leader, coach, mentor and role model for new and incumbent employees by setting examples of appropriate behavior, work habits and attitudes towards patients, co-workers, supervisors and the company at the facility, and area level. + Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. + Identifies expected outcomes, documents, and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. + Ensures patient awareness related to transplant and treatment modality options. + Participates in education and quality improvement projects at the facility and area level as directed by Supervisor. + May serve as a Preceptor to new employees. + Required to complete CAP requirements to maintain or advance. + Performs all other duties as assigned by Supervisor. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. + This position requires frequent, prolonged periods of standing and the employee must be able to bend over. + The employee may occasionally be required to move, with assistance, machines, and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. + May be exposed to infectious and contagious diseases/materials. + Day to day work includes desk work, computer work and interaction with patients, facility/hospital staff and physicians. + The position may require travel to training sites or other facilities. + May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. **SUPERVISION:** + Assigned oversight of Patient Care Technicians//LVN/LPNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: + Successful completion of all FKC education and training requirements for new employees. + Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. **EDUCATION and LICENSURE:** + Graduate of an accredited School of Nursing. + Current appropriate state licensure. + Current or successful completion of CPR BLS Certification + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND REQUIRED SKILLS:** + Entry level for RNs with minimum of 2 years of Nephrology Nursing experience **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical operations. As the facility leader, you will be part of a close-knit, collaborative team responsible for delivering unique care plans and providing dialysis treatment to patients facing end stage renal disease or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning for our managers. The curriculum will cover onboarding, essential functions, leading your business, and advanced leadership. As a Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL RESPONSIBILITIES AND DUTIES** CLINIC OPERATIONS: + Manages the operations of the clinic, including costs, processes, staffing, and quality standards. + Provides leadership, coaching, and development plans for all direct reports. + Partners with internal Human Resources, Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies Program. + Maintains integrity of medical and operations records and complies with all data collections and auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + Responsible for all required network reporting and on-site state or federal surveys. PATIENT CARE: + Coordinates all aspects of patient care with the appropriate staff members, from admission through discharge of the patient. + Ensure education of the patient regarding quality measures, transplant options, modality awareness, and access care. + Acts as a resource for the patient and family to address concerns and questions. + Accountable for timely completion of patient care assessments and care plans. + Manages timely patient schedules to ensure facility efficiency and develops action plans for missed treatments. + Plans, coordinates, and validates patient eligibility for treatment. + Reports changes in patient status regarding any clinical, insurance, or travel and transportation issues. STAFF: + Participates in the selection and hiring of new team members and ensures completion of new hiring orientation and mandatory trainings. + Responsible for all patient care employees completing appropriate training courses and that licensures/certifications are current. + Provides support for all clinical staff members at regular intervals and encourages professional growth. + Maintains current knowledge regarding company benefits, policies, procedures, and processes. + Completes employee evaluations and establishes annual goals. + Documents any disciplinary actions and confers with the clinic Director of Operations and Human Resources when needed. + Manages staff scheduling and payroll. PHYSICIANS: + Facilitates the application process for physician privileges and compliance with Fresenius Medical Care Medical Staff By-Laws. + Responsible for strong physician relationships and ensures regular and effective communication. + Participates in Governing Body, an interdisciplinary team for each region including MSWs, Dietitians, MDs, DOs etc. that governs policies. **EDUCATION AND REQUIRED CREDENTIALS:** + Bachelor's Degree or an equivalent combination of education and experience. + Graduate of an accredited School of Nursing (RN). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+ years business operations experience in a healthcare facility. + 12 months experience in clinical nursing. + 6 months chronic or acute dialysis nursing experience. + Successfully pass the Ishihara Color Blind Test. + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + Day-to-day work includes desk and personal computer work and interaction with patients, facility staff, and physicians + Position may require travel between assigned facilities and various locations within the community and/or travel to regional, business unit, and corporate meetings may be required. + The work environment is characteristic of a healthcare facility with air temperature control and moderate noise levels. + May be exposed to infectious and contagious diseases/materials. + Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting, moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**P** **ossible hybrid opportunity available!** **About this role:** As a Dietitian with Fresenius Medical Care, you will be a valuable member of the interdisciplinary team and a part of a close-knit, collaborative team responsible for delivering unique nutritional care to patients facing end stage renal disease. Our RDs build strong bonds and lasting relationships with patients, their families, and all team members. **How you grow or advance:** We offer a Core Curriculum program, which includes CEUs, specifically for dietitians on all the topics of renal nutrition therapy. Our orientation and training program is designed to develop experts in the field of renal nutrition, allowing you to work at the top of your license. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL RESPONSIBILITIES AND DUTIES:** + Assesses patient's knowledge and provides education regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process. + Completes nutritional assessment and works with the interdisciplinary team to develop an individualized comprehensive plan of care for patients. + Maintains complete and accurate medical records including progress notes. + Provides ongoing assessment and counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished or at-risk patients and works collaboratively with the interdisciplinary team to identify appropriate interventions, resources, or solutions. + Monitors, adjusts, and documents response to nutrition therapy and addresses any issues impacting the patient's ability to achieve the goals. + Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician's prescription of Kt/V. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Identifies candidates to refer to physician for nutritional supplements. + Communicates with physician and/or facility staff as appropriate. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. **EDUCATION:** + Registered Dietitian as per Commission on Dietetic Registration. + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS:** + 1+ year experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. **Education/Communication:** + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

Area Float **PURPOSE AND SCOPE:** The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) for new employees who meet the RN CAP 2 criteria or attained through advancement from RN CAP 1. This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention, and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs, and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state, and federal regulations. + Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. + Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. + Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. + Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. + Initiates or assists with emergency response measures. + Serves as a resource, leader, coach, mentor and role model for new and incumbent employees by setting examples of appropriate behavior, work habits and attitudes towards patients, co-workers, supervisors and the company at the facility, and area level. + Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. + Identifies expected outcomes, documents, and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. + Ensures patient awareness related to transplant and treatment modality options. + Participates in education and quality improvement projects at the facility and area level as directed by Supervisor. + May serve as a Preceptor to new employees. + Required to complete CAP requirements to maintain or advance. + Performs all other duties as assigned by Supervisor. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. + This position requires frequent, prolonged periods of standing and the employee must be able to bend over. + The employee may occasionally be required to move, with assistance, machines, and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. + May be exposed to infectious and contagious diseases/materials. + Day to day work includes desk work, computer work and interaction with patients, facility/hospital staff and physicians. + The position may require travel to training sites or other facilities. + May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. **SUPERVISION:** + Assigned oversight of Patient Care Technicians//LVN/LPNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: + Successful completion of all FKC education and training requirements for new employees. + Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. **EDUCATION and LICENSURE:** + Graduate of an accredited School of Nursing. + Current appropriate state licensure. + Current or successful completion of CPR BLS Certification + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND REQUIRED SKILLS:** + Entry level for RNs with minimum of 2 years of Nephrology Nursing experience **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** " **EOE, disability/veterans**

**Possible hybrid opportunity available!** **PURPOSE AND SCOPE:** Provides nutritional services for the facility's in-center and home patients as applicable in order to maximize the patient's nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) activities. Actively participates in process improvement activities that enhance the likelihood that patients will achieve their individualized patient-specific goals as determined by the patient's physician. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Assesses patient's knowledge of diet and kidney disease and provides education appropriate to patient's learning needs regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides patient specific detailed education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process. + Completes nutritional assessment and participates in the interdisciplinary comprehensive assessments. + Participates with the interdisciplinary team in the development of a written, individualized comprehensive plan of care that specifies the services necessary to address the patient's needs, in accordance with established Federal and, where applicable, state licensure guidelines. + Calculates diet prescription according to standard of practice. + Completes progress notes on all chronic dialysis patients according to established FMCNA guidelines. Maintains complete and accurate documentation of all appropriate information in medical record according to established FMCNA policies and Federal and state regulations. + Provides patient with ongoing nutrition assessment and outcome-oriented nutrition counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished patients as well as patients at risk for malnutrition and works collaboratively with interdisciplinary team to identify appropriate interventions, resources or solutions. Reviews each patient's albumin level and body weight at least monthly. Implements plan of care with involvement of patient/family/caregiver. + Monitors adherence and response to nutrition therapy, adjusts therapy as needed to achieve and sustain an effective nutritional status, documents why the patient was unable to achieve the goals and implements the plan of care to address issues impacting the patient's ability to achieve the goals. + Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician's prescription of Kt/V. + Collaborates with the interdisciplinary team on management and recommendations for mineral metabolism and renal bone disease, anemia and iron status, nutritional status, psychosocial status, vascular access, modality, rehabilitation status and sodium/volume control. + Adheres to FMCNA algorithm and medical record policies. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Collaborates and coordinates with team members in provision of Pre-ESRD education as appropriate. + When appropriate, works with Case Manager to coordinate plan of care for patient education and identifies candidates to refer to physician for nutritional supplements, as per disease management agreements. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Communicates with physician and/or facility staff regarding lab results as appropriate. + Communicates lab results and recommended treatment changes to providers of patient care in nursing facilities (i.e., hospitals, short term and long-term care facilities). + Participates in pertinent staff meetings (i.e., general staff, quality improvement), Care plan meetings, and others as applicable. + Consults with FMS Corporate Dietitian regarding nutrition concerns as needed. + Maintains and improves knowledge and skills for a competent and innovative practice. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. + Collaborates with interdisciplinary team, ensuring that all work areas are safe and clean. + Other nutrition management duties as assigned. + Performs other related duties as assigned. **PHYSICAL DEMANDS AND WORKING CONDITIONS** **:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. + The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS** **:** + Registered Dietitian as per Commission on Dietetic Registration + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS** **:** + Minimum of 1-year professional work experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. + Demonstrated leadership competencies and skills for the position, including ability to teach, strong organizational skills, excellent communication, customer service, relationship development, results orientation, team building and decision making. + Able to perform responsibilities with minimum supervision. + Basic computer skills required. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Responsible for the setup and operation of hemodialysis machines. Assist in the maintenance of a safe and clean working environment. Supports the organization commitment to the Quality Enhancement Program (QEP) and CQI Activities, including those related to patient satisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achieve the organization Quality Enhancement Goals (QEP). **PRINCIPAL** **DUTIES** **AND** **RESPONSIBILITIES:** **Patient Related** Education: + Assist other health care members in providing patient specific detailed education regarding adequacy measures where appropriate - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM), and regarding disease process/access. Treatment: + Welcome assigned patients and inquire as to their wellbeing since their last treatment. + Evaluate vascular access for patency, perform vascular access cannulation, and perform administration of heparin as delegated or as allowed by state law. + Obtain necessary pre and post treatment vital signs and weight and perform vascular access evaluation pre- treatment + Initiate dialysis treatment according to prescribed orders including blood flow (QB) and dialysate flow (QD). + Evaluate intradialytic problems and provide intervention as prescribed by physician order or as directed. + Monitor patients' response to dialysis therapy. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures and evaluate patient prior to termination of venous access - standing & sitting blood pressure + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient prior to discharge. + Perform and record Pre and Post dialysis evaluation, weight, and vital signs with initial identification + Responsible for calculating and entry of individual patients' dialysis machine programming for Ultrafiltration (UF) goal; treatment time; and UF modeling as prescribed. + Responsible for ensuring appropriate safety alarms are enabled, including Narrow Venous Limits, (NVL) 160. + Record accurate and timely information regarding vital signs and treatment parameters onto the Hemodialysis Treatment Sheet with initial identification + Responsible for accurate documentation of information related to patient treatment including completion of Hemodialysis Treatment Sheet and, if applicable, progress notes. + Report any significant information and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the registered nurse or supervisor. + Perform and document any intervention for unusual patient status and document patients' response to intervention. + Evaluate patients' vascular access during treatment including arterial and venous monitoring pressures, provide appropriate intervention as needed, document and report any unusual findings to the registered nurse or supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. + Ensure that all blood spills are immediately cleaned with appropriate disinfectant according to facility policy. + Prepare, organize, and efficiently utilize supplies and equipment to prevent wastage. + Monitors patients performing self-care under the supervision of RN. **Staff Related** + Assists in training of applicable direct patient care staff on appropriate programs under the supervision of a nurse. **Education/Communication:** + Follows all organization business policies, procedures and systems incorporated into training, including compliance with ethical business practices + Maintain environmental integrity and aesthetics - ensure all areas are safe and clean. + Clean and disinfect dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. + Conduct all tasks necessary for preparation for dialysis treatment and document where appropriate and perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. **RECORD KEEPING:** + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected by appropriate staff. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare/print lab requisitions for prescribed or stat Lab specimens according to laboratory destination. + Collect, label, appropriately prepare and store lab samples according required laboratory specifications. + Ensure collection of lab specimens by appropriate lab courier. **INFECTION CONTROL:** + Assists in collecting information for infection control audits. + Supports staff and patient Adherence to infection control practices. + Follows infection control Policies and Procedures + Participates in and reinforces infection control education of patients and families under the direction of the CM or designee as allowed by state law. **TRANSITIONAL CARE UNIT:** + Follows all newly admitted patients through their first 4 weeks of dialysis and coordinating their transitional dialysis care + Reinforces all education and care related matters as it relates to the new patient as allowed by state law + Liaisons with appropriate FKC staff members to provide the best patient experience including making sure all disciplines are scheduled to see patient according to plan. + Assists in assuring patient understanding or home dialysis products, benefits of home and how home dialysis can work for them. + Sets and preforms a treatment on all machines used in the transitional care unit. + Assist in assuring patient understanding of treatment options including demonstration of the peritoneal dialysis set-up. + Assists with coordination of transition to patient's modality choice. + Assists with supply ordering and inventory for TCU **PHYSICAL** **DEMANDS** **AND** **WORKING** **CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made. + Day to day work includes desk and personal computer work and interaction with patients, facility staff, and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials + The position provides direct patient care that regularly involves heavy lifting and moving of patients and assisting with ambulation.Equipmentaidsand/orcoworkersmayprovideassistance.Thispositionrequiresfrequent,prolongedperiodsof standing and the employee must be able to bend over. The employee may occasionally be required to push and/or pull equipment, exerting up to 15 pounds of force. The employee may be required to lift and to lower solutions on a frequent basis of up to 30 lbs., and on an occasional lift basis up to 40 lbs., as high as 5 feet. There is a two-person assist program and "material assist" devices for the heavier items. **EDUCATION** **AND** **LICENSES:** + HighSchooldiplomaorG.E.D. required. + Must meet Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification requirements within the required state or CMS timeline. + Allappropriatestatelicensure,education,andtraining(ifany) required. + Demonstrated commitment to organization culture, values, and customer service standards **EXPERIENCE AND REQUIRED SKILLS** **:** + Previouspatientcareexperienceinahospitalsettingorarelatedfacility preferred. + Continued employment is dependent on successful completion of the organization dialysis training program and successful completion of CPR certification. **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

PURPOSE AND SCOPE: The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations. PRINCIPAL DUTIES AND RESPONSIBILITIES: All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. · Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. · Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. · Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. · Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. · Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. · Initiates or assists with emergency response measures. · Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. · Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. · Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. · Ensures patient awareness related to transplant and treatment modality options. · Required to complete CAP requirements to advance. · Performs all other duties as assigned by Supervisor. PHYSICAL DEMANDS AND WORKING CONDITIONS: The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. · The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. · This position requires frequent, prolonged periods of standing and the employee must be able to bend over. · The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. · The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. · May be exposed to infectious and contagious diseases/materials. · Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. · The position may require travel to training sites or other facilities. · May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above. SUPERVISION: Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: · Successful completion of all FKC education and training requirements for new employees. · Must have a minimum of 9 months experience as a RN. · Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN. EDUCATION and LICENSURE: · Graduate of an accredited School of Nursing. · Current appropriate state licensure. · Current or successful completion of CPR BLS Certification. · Must meet the practice requirements in the state in which he or she is employed. EXPERIENCE AND REQUIRED SKILLS: · Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. · Chronic/acute hemodialysis experience (preferred). **Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**P** **ossible hybrid opportunity available!** **About this role:** As a Dietitian with Fresenius Medical Care, you will be a valuable member of the interdisciplinary team and a part of a close-knit, collaborative team responsible for delivering unique nutritional care to patients facing end stage renal disease. Our RDs build strong bonds and lasting relationships with patients, their families, and all team members. **How you grow or advance:** We offer a Core Curriculum program, which includes CEUs, specifically for dietitians on all the topics of renal nutrition therapy. Our orientation and training program is designed to develop experts in the field of renal nutrition, allowing you to work at the top of your license. **Our culture:** We believe our employees are our most important asset - we value, care about, and support our people. We are there when you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters strike, or providing financial support when personal hardship hits, we take care of our people. **Our focus on diversity:** We have built a nurturing environment that welcomes every age, race, gender, sexual orientation, background, and cultural tradition. We have a diverse range of employee resource groups (ERGs) to encourage employees with similar interests, goals, social and cultural backgrounds, or experiences to come together for professional and personal development, discussion, activities, and peer support. Our diverse workforce and culture encourage opportunity, equity, and inclusion for all, which is a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in the lives of people living with kidney disease. If this sounds like the career and company you have been looking for, and you want to be a vital part of the future of healthcare, apply today. **PRINCIPAL RESPONSIBILITIES AND DUTIES:** + Assesses patient's knowledge and provides education regarding the relationship of diet and kidney disease and the impact on the treatment process. + Provides education to patient/family/caregiver regarding nutritional status, adequacy measures and results, fluid status, and all nutrition related lab parameters pertaining to their disease process. + Completes nutritional assessment and works with the interdisciplinary team to develop an individualized comprehensive plan of care for patients. + Maintains complete and accurate medical records including progress notes. + Provides ongoing assessment and counseling necessary to assist patient in achieving and sustaining an effective nutritional status. + Identifies malnourished or at-risk patients and works collaboratively with the interdisciplinary team to identify appropriate interventions, resources, or solutions. + Monitors, adjusts, and documents response to nutrition therapy and addresses any issues impacting the patient's ability to achieve the goals. + Collaborates with the interdisciplinary team on Urea Kinetic Modeling recommendations to achieve the physician's prescription of Kt/V. + Reports on nutrition QAI results and participates in the interdisciplinary QAI program. + Reviews nutrition related lab results: + Counsels patient and/or caregiver and formulates appropriate action. + Recommends treatment changes to the interdisciplinary team as appropriate. + Identifies candidates to refer to physician for nutritional supplements. + Communicates with physician and/or facility staff as appropriate. + Maintains dietetic registration and continuing education hours as specified by American Dietetic Association and state licensure regulations where applicable. **EDUCATION:** + Registered Dietitian as per Commission on Dietetic Registration. + Board Certified Specialist in Renal Nutrition encouraged. + Current state licensure if applicable. **EXPERIENCE AND SKILLS:** + 1+ year experience in clinical nutrition as a Registered Dietitian. + Previous renal experience preferred. **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. + Day to day work includes desk and personal computer work and interaction with patients, facility staff and physicians. The position requires travel between assigned facilities and various locations within the community. Travel to regional, Business Unit and Corporate meetings may be required. + The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. **EOE, disability/veterans**