Fresenius Medical Care North America Holdings Limited Partnership jobs in Milwaukee, WI

**No Dialysis specific experience required!! Comprehensive, on-the-job training is provided!** 2000 East Layton Ave. Ste 200 St Francis, WI 53235 **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. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA 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 FMCNA 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 FMC Quality Enhancement Goals (QEP). **DUTIES / ACTIVITIES:** CUSTOMER SERVICE: + Responsible for driving the FMS culture through values and customer service standards. + Accountable for outstanding customer service to all external and internal customers. + Develops and maintains effective relationships through effective and timely communication. + Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner. **PRINCIPAL RESPONSIBILITIES AND DUTIES** PATIENT CARE: + 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. + Welcome assigned patients and inquire as to their well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual findings to nurse supervisor. + Obtain necessary pre and post treatment vital signs and weight. Report unusual findings to nurse supervisor. + Perform vascular access evaluation pre-treatment and report unusual findings to nurse supervisor. + Perform vascular access cannulation and report any difficulties in cannulation or unusual findings to nurse supervisor. + Perform administration of Heparin as delegated or as allowed by state law. + 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 and report any unusual findings to nurse supervisor. + Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. + Discontinue dialysis treatment according to established procedures, + Evaluate patient prior to termination of venous access - standing & sitting blood pressure. + Obtain Hemostasis and apply appropriate dressings. + Evaluate the patient for prior to discharge and report any unusual findings to nurse supervisor. + 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; Sodium (Na) modeling; 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 nurse supervisor. + Observe patient, and conduct machine safety checks according to facility policy. Report any change or unusual findings to the nurse 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 nurse supervisor. + Obtain all prescribed laboratory testing and prepare specimens for collection. MAINTENANCE/TECHNICAL: + 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. + Perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). + Initiate Solution Delivery System (SDS) system. + 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. CLERICAL & ADMINISTRATIVE: + Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. + Enters all treatment data into the designated clinical application accurately and in a timely manner. + Review treatment sheets for completeness, ensure nursing signatures are documented, and ensure omitted entries are completed or corrected where appropriate. + Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. + Prepare 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. OTHER: + Perform additional duties as assigned. **ADDENDUM FOR PATIENT CARE TECHNICIANS WORKING IN THE HOME PROGRAMS (NOT HOME ASSIST):** Assisting the HT RN: + May assist HT RN on Home Visit as directed + Reinforces PD / HHD education under supervision of qualified HT RN + Schedules and contacts patients regarding appointments + Weigh patient and obtain vital signs + Collect treatment records and review for completion. Notify RN of incomplete / missing records. + Cleaning and prepping treatment room; prep charts + Preparing lab tubes and requisitions & assisting with lab draw days both pre and post draw (PCT certified phlebotomy or per state regulations) + Clerical duties as assigned (faxing, mailing to physician offices etc.) + Obtain home hemo water sampling as directed by the HT RN + Set-up of the home hemo machine and PD Cycler. + Assist with exit site care when directed by HT RN. + Warm dialysate solution when directed by the HT RN + Draw dialysate solution for testing as directed by the HT RN + Creates and sends patient reminders (supply inventory for order, Kt/V collection, bringing meds to clinic visit for review) + Assembles/breaks down charts/thins charts + Maintains logs as directed and applicable + Inventory of Home Program + Maintains par levels of home department supplies + Files home patient packing slips/invoices + Inventory for Patients + Assists patient with supply management and contacting customer service **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 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. 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 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** + Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification or High School diploma or G.E.D. and must meet certification requirements within the required state or CMS timeline. + All appropriate state licensure, education and training (if any) required. **EXPERIENCE AND REQUIRED SKILLS** + Previous patient care experience in a hospital setting or related facility preferred. + Continued employment is dependent on successful completion of the FMCNA 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**

+ Monday - Friday schedule, no nights/weekends/holidays/on call + Rewarding development of direct patient care staff + Structured professional development to enhance personal growth + Collaboration with operational and clinical leaders to ensure quality patient care is provided to our dialysis patients + Facilitation and implementation of our world-class dialysis training program + Opportunity for professional development by participating in national projects related to the development of our staff + Ability to support all dialysis modalities **PURPOSE AND SCOPE:** Supports the training and education of employees based in company facilities and programs within an assigned geographical area. Delivers standardized, competency based, training and development programs including new employee orientation, preceptor training, facility specific in- services, and clinical, quality, and customer service training programs to promote quality patient care, and achieve Area, Regional and/or Enterprise wide initiatives & goals. **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, but not limited to, 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. + 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 approximately 35-80% 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 North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**PURPOSE AND SCOPE:** The student intern 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. The student intern functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed social worker in accordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federal agencies. Assist in the maintenance of a safe and clean working environment. Supports the FMCNA 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 FMC Quality Enhancement Goals (QEP). **DUTIES / ACTIVITIES:** An integral part of Social Work education that promotes students' identification with the purposes, values and ethics of the profession; fosters the integration of empirical and practice-based knowledge; and promotes the development of professional competence (CSWE Educational Policy and Accreditation Standards). A minimum number of required field education hours are established by the CSWE. **The social worker student/intern may under direct guidance of a Licensed Social Worker:** **CUSTOMER SERVICES:** + Responsible for driving the FMS culture through values and customer services standards. + Accountable for outstanding customer service to all external and internal customers. + Develops and maintains effective relationships through effective and timely communication. + Takes initiative and action to respond, resolve, and follow up regarding customer services issues with all customers in a timely manner. **PRINCIPLE RESPONSIBILITIES AND DUTIES RELATED TO PATIENT CARE:** **Patient Assessment/Care Planning Counseling:** + As a member of the interdisciplinary team, assesses patients' psychosocial status, strengths and areas of need that may affect rehabilitation and optimal treatment outcomes as part of the comprehensive patient assessment. + Participates in care planning in collaboration with the patient and healthcare team to identify effective interventions that will help the patient meet rehabilitation, treatment goals, and improve quality of life. + Utilizes FMS Ultra Care patient education programs, established social work theory and methods and quality of life measurement instruments as part of assessment and care planning to resolve barriers and meet patient treatment goals. + Provides established outcomes driven psycho-educational counseling methods aimed at improving areas of need, treatment adherence, vocational/educational rehabilitation and/or quality of life. + Provides supportive and goal directed counseling to patients who are seeking transplant. + Assesses patient awareness of advance directives; assists with accessing advance directive forms/information and facilitates discussion of advance directive wishes, if necessary, with the healthcare team and the patient's family/support persons. + Will provide general information about Do Not Resuscitate Orders and Advanced Directives. + Provides information and assists the team and patient with referral to community resources (home health services, vocational rehabilitation, etc.) to facilitate optimal treatment outcomes. + Provides usual care and/or Social Work Intensive to address non-adherence and quality of life concerns for all patients. + Knowledgeable of and adheres to FMCNA Social Work Policy, including documentation. **Patient Education:** + Assess patient knowledge of kidney disease for barriers that may affect adherence to treatment. Works with patient, family and health care team to provide education tailored to the patient's learning style and needs. + With other members of the interdisciplinary team, provides appropriate information about all treatment modalities. Facilitates the transplant referral process and collaborates with interdisciplinary team, if delegated by Clinical Manager. + Provides ongoing education to patient/family regarding psychosocial issues related to End Stage Renal Disease (ESRD) and all support services that are available. + Reviewed patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient and/or the patients' representative to ensure patients' understanding of the rights and expectations of them. + Collaborates with the team on appropriate QAI activities. **Insurance and Financial Assistance:** + Maintains current knowledge regarding local vocational/educational rehabilitation programs and assist patients with referral and access to vocational rehabilitation to enable them to remain employed, become employed or receive education. + Understands FMCNA financial policies and procedures as they related to patient services. Collaborate with Financial Coordinators to educate patients about programs that may be available to assist with uncovered services, how to resolve billing concerns, and understand financial responsibilities. **Staff Related:** + Works with the administrative support staff to maintain updated patient resource lists (e.g. maintain updated list of transportation resources). + Develops and provides training to staff pertaining to psychosocial topics as needed. Trains staff in Ultra Care Programs as needed. + Other 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, 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. **EDUCATION:** High School diploma or G.E.D. **EXPERIENCE AND REQUIRED SKILLS:** Preferred outstanding customer service to all external and internal customers. Possess the desire to deliver superior care to our patients and embrace Fresenius' mission and values. **RELATIONSHIPS:** The Intern cannot work under the supervision of a family member. The Intern cannot care for a patient who is a family member. If an Intern's family member is a patient at the facility in which they work, the Intern will be scheduled to work on days the patient is not in the facility or will be assigned to another patient. **SUPERVISION:** The Clinical Manager assigns and closely monitors all SW Intern assignments with direct supervision from a SWFI based on the agreed education plan. **OTHER:** Performs additional duties as assigned. **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 hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff Registered Nurse, to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA 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 FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. + Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. + Assesses daily patient care needs and develops appropriate patient care assignments. + Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. + Participates in staff training and orientation of new staff as assigned + Participates in all required staff meetings as scheduled. **PATIENT RELATED:** Education: + Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). + Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. + Discusses with patient, and records education related to diet/fluid and medication compliance. + Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). + Ensures transplant awareness, modality awareness, and drive catheter reduction. + Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. Dialysis Treatment: + Provides safe and effective delivery of care to patients with ESRD. + Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. + Assesses patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. + Identifies and communicates patient related issues to Team Leader or physician. + Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. + Actively participates in the pre evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. + Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. + Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. + Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. Laboratory-related: + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. + Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. + Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. + Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. + Ensures that all labs are directed and delivered to appropriate labs. + Reports alert/panic and abnormal labs results to appropriate physician. + Ensures lab results are forwarded to physicians as requested. General duties: + Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. + Maintains overall shift operation in a safe, efficient, and effective manner. + Act as a resource for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. + Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. + Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. + Oversees all documentation of patient information. + Maintains facility drug list for all required stock medications. + Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. + Ensures verification and availability of adequate emergency equipment. + Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. + Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. + Maintains appropriate recording of controlled substances as required by law. + Assists with the coordination of patient transportation if necessary. **MAINTENANCE/TECHNICAL:** + Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. + Ensures competency in the operation of all dialysis-related equipment safely and effectively. + Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. + Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. **MEDICAL RECORDS & DOCUMENTATION:** General + Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. + Ensures all appropriate patient related treatment data is entered into the Medical Information System. + Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. + Ensures and verify accuracy of Patient Care Technician documentation. Daily + Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. + Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. Monthly + Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. + Completes monthly nurses' progress note. + Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). + Reviews transplant status and follows established procedure regarding appropriate action to be taken. + Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. + Completes any long-term programs that are due. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **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 and 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. up 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. + 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 accommodation can be made. **SUPERVISION:** + None **EDUCATION** **:** + Graduate of an accredited School of Nursing. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate supervisor or my Human Resources representative. **ADDENDUM:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. **EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity** **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**

Sign On Bonus Available PURPOSE AND SCOPE: Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior and accepted methods of social work practice. Works with the health care team to promote positive adjustment, rehabilitation and improved quality of life for our patients. In collaboration with the interdisciplinary team, informs, educates and supports staff in understanding the emotional, psychological and behavioral impact of Chronic Kidney Disease on the patient and family to ensure comprehensive quality care of our patients. Supports the Fresenius Kidney Care (FKC) commitment to the Quality Indicators and Outcomes and Quality Assessment and Improvement (QAI) Activities, including those related to patient satisfaction and quality of life and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FKC Quality Goals. This is an entry level MSW role. PRINCIPAL DUTIES AND RESPONSIBILITIES: Patient Assessment / Care Planning / Counseling As a member of the interdisciplinary team, assesses patients' psychosocial status, strengths and areas of need that may affect rehabilitation and optimal treatment outcomes as part of the comprehensive patient assessment. Participates in care planning in collaboration with the patient and healthcare team to identify effective interventions that will help the patient meet rehabilitation, treatment goals, and improve quality of life. Utilizes FKC patient education programs, established social work theory and methods, social work focused interventions, and quality of life measurement instruments as part of assessment and care planning to address barriers and meet patient treatment goals. Provides monitoring and interventions for the patient to adjust to dialysis and achieve optimal psychosocial status and quality of life. Provides supportive counseling services to patients as permitted within the scope of their clinical training and state license. Provides educational and goal directed counseling to patients who are seeking transplant. Provides information and assists the team and patient with referral to community resources (home health services, vocational rehabilitation, etc.) to facilitate optimal treatment outcomes. Maintains current knowledge regarding local vocational/educational rehabilitation programs and assist patients with referral and access to vocational rehabilitation to enable them to remain employed, become employed or receive education. Assesses patient awareness of advance directives; assists with accessing advance directive forms/information and facilitates discussion of advance directive wishes, if necessary, with the healthcare team and the patient's family/support persons. In collaboration with the physician and nurse, participates in the discussion of patient DNR status in the facility to ensure patient and/or family understand and make an informed decision about their care. Knowledgeable of and adheres to FMCNA Social Work Policy and Measuring Patient Physical and Mental Function Policy, including documentation. Documents based on MSW interaction and interventions provided to patient and/or family. Quality Provides psychosocial support and/or Social Work Focused Interventions to address non-adherence, quality outcome, and quality of life concerns for all patients based on acuity level. Participates in monthly Quality review meetings with the interdisciplinary team. Reports on quality indicators related to adherence, such as Missed and Shortened Treatments, Quality of Life Trends, and Service Recovery. Patient Education Assesses patient knowledge of kidney disease for barriers that may affect adherence to treatment. Works with patient, family and health care team to provide education tailored to the patient's learning style, communication barriers, and needs. With other members of the interdisciplinary team, provides appropriate information about all treatment modalities. Facilitates the transplant referral process and collaborates with interdisciplinary team on transplant waitlist management. Provides ongoing education to patient/family regarding psychosocial issues related to End Stage Renal Disease (ESRD) and all support services that are available. Reviews patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient and/or the patients' representative to ensure patients' understanding of the rights and expectations of them. Collaborates with the team on appropriate QAI activities. Patient Admission and Continuity of Care Reviews Patient Rights and Responsibilities, Grievance Procedure & Important Numbers Handout, FKC Non-discrimination policy, DNR Statement (if applicable) and address any immediate needs/concerns. Understands the referral and admission process and supports the clinic in regard to the patient needs for scheduling to maximize adherence and adjustment. The Social Worker will interview the patient to identify root causes or concerns for the discharge request, (i.e. transfer to hospice, relocation, dissatisfaction with services or staff) and share causes/concerns with operational leadership. Insurance and Financial Assistance Collaborates and functions as a liaison for patient with Insurance Coordinators to address issues related to insurance. In collaboration with Insurance Coordinators, provides information and education to patients about payment to dialysis (federal, state, commercial insurance, state renal programs, AKF HIPP, and entitlement programs). Collaborates with the Insurance Coordinator of any changes to patient state that impacts insurance i.e. transplantation, discharged, loss of coverage, or extended travel. Refers patients to patient billing solutions (PBS) department for questions/concerns in regard to treatment related bills Staff Related Assists with interview process and decision to hire new personnel if requested by SW Manager/Senior Manager. Works with the administrative support staff to maintain updated patient resource lists (e.g. maintain updated list of transportation resources). Provides training to staff pertaining to psychosocial topics as needed. Contributes and participates with weekly team huddles. Discusses any urgent patient issues with staff. Adheres to work defined caseload guidelines based on state regulatory requirements. 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. Travel required (if multiple facilities or home visits, if applicable) SUPERVISION: None EDUCATION AND REQUIRED CREDENTIALS: Masters in Social Work Must have state required license Meets the applicable scope of practice board and licensure requirements in effect in the State in which they are employed EXPERIENCE AND SKILLS: 0 - 2 years' related experience EOE, disability/veterans

No dialysis experience required as we provide extensive on-the-job training! 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. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA 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 FMCNA 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 FMC Quality Enhancement Goals (QEP). DUTIES / ACTIVITIES: CUSTOMER SERVICE: Responsible for driving the FMS culture through values and customer service standards. Accountable for outstanding customer service to all external and internal customers. Develops and maintains effective relationships through effective and timely communication. Takes initiative and action to respond resolve and follow up regarding customer service issues with all customers in a timely manner. PRINCIPAL RESPONSIBILITIES AND DUTIES PATIENT CARE: 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. Welcome assigned patients and inquire as to their well-being since their last treatment. Report any complaints or observations to the nurse supervisor. Evaluate vascular access for patency and report any unusual findings to nurse supervisor. Obtain necessary pre and post treatment vital signs and weight. Report unusual findings to nurse supervisor. Perform vascular access evaluation pre-treatment and report unusual findings to nurse supervisor. Perform vascular access cannulation and report any difficulties in cannulation or unusual findings to nurse supervisor. Perform administration of Heparin as delegated or as allowed by state law. 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 and report any unusual findings to nurse supervisor. Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. Discontinue dialysis treatment according to established procedures Evaluate patient prior to termination of venous access - standing & sitting blood pressure. Obtain Hemostasis and apply appropriate dressings. Evaluate the patient for prior to discharge and report any unusual findings to nurse supervisor. 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; Sodium (Na) modeling; 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 nurse supervisor. Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the nurse 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 nurse supervisor. Obtain all prescribed laboratory testing and prepare specimens for collection. MAINTENANCE/TECHNICAL: 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. Perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). Initiate Solution Delivery System (SDS) system. 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. CLERICAL & ADMINISTRATIVE: Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. Enters all treatment data into the designated clinical application accurately and in a timely manner. Review treatment sheets for completeness ensure nursing signatures are documented and ensure omitted entries are completed or corrected where appropriate. Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. Prepare 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. OTHER: Perform additional duties as assigned. ADDENDUM FOR PATIENT CARE TECHNICIANS WORKING IN THE HOME PROGRAMS (NOT HOME ASSIST): Assisting the HT RN: May assist HT RN on Home Visit as directed Reinforces PD / HHD education under supervision of qualified HT RN Schedules and contacts patients regarding appointments Weigh patient and obtain vital signs Collect treatment records and review for completion. Notify RN of incomplete / missing records. Cleaning and prepping treatment room; prep charts Preparing lab tubes and requisitions & assisting with lab draw days both pre and post draw (PCT certified phlebotomy or per state regulations) Clerical duties as assigned (faxing mailing to physician offices etc.) Obtain home hemo water sampling as directed by the HT RN Set-up of the home hemo machine and PD Cycler. Assist with exit site care when directed by HT RN. Warm dialysate solution when directed by the HT RN Draw dialysate solution for testing as directed by the HT RN Creates and sends patient reminders (supply inventory for order Kt/V collection bringing meds to clinic visit for review) Assembles/breaks down charts/thins charts Maintains logs as directed and applicable Inventory of Home Program Maintains par levels of home department supplies Files home patient packing slips/invoices Inventory for Patients Assists patient with supply management and contacting customer service 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 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. 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 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 Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification or High School diploma or G.E.D. and must meet certification requirements within the required state or CMS timeline. All appropriate state licensure education and training (if any) required. EXPERIENCE AND REQUIRED SKILLS Previous patient care experience in a hospital setting or related facility preferred. Continued employment is dependent on successful completion of the FMCNA 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

No on-call Every other Saturday required Sundays off Career Advancement Program (CAP) to advance your nephrology career from novice to expert 10-12 hour shifts Clinic Hours of Operation: 5am to 830pm 5am to 530pm Clinic Location: 5125 W. Morgan Avenue Greenfield, WI 53220 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 1 year of Nephrology Nursing experience in the last two years as a RN. Minimum of 9 months experience as a Registered Nurse (preferred). 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:** Provides psychosocial services to patients treated by the facility including in-center and home dialysis patients (if applicable) utilizing Social Work Theory of Human Behavior and accepted methods of social work practice. Works with the health care team to promote positive adjustment, rehabilitation and improved quality of life for our patients. In collaboration with the interdisciplinary team, informs, educates and supports staff in understanding the emotional, psychological and behavioral impact of Chronic Kidney Disease on the patient and family to ensure comprehensive quality care of our patients. Supports the Fresenius Kidney Care (FKC) commitment to the Quality Indicators and Outcomes and Quality Assessment and Improvement (QAI) Activities, including those related to patient satisfaction and quality of life and actively participates in process improvement activities that enhance the likelihood that patients will achieve the FKC Quality Goals. This is an entry level MSW role. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Patient Assessment / Care Planning / Counseling + As a member of the interdisciplinary team, assesses patients' psychosocial status, strengths and areas of need that may affect rehabilitation and optimal treatment outcomes as part of the comprehensive patient assessment. + Participates in care planning in collaboration with the patient and healthcare team to identify effective interventions that will help the patient meet rehabilitation, treatment goals, and improve quality of life. + Utilizes FKC patient education programs, established social work theory and methods, social work focused interventions, and quality of life measurement instruments as part of assessment and care planning to address barriers and meet patient treatment goals. + Provides monitoring and interventions for the patient to adjust to dialysis and achieve optimal psychosocial status and quality of life. + Provides supportive counseling services to patients as permitted within the scope of their clinical training and state license. + Provides educational and goal directed counseling to patients who are seeking transplant. + Provides information and assists the team and patient with referral to community resources (home health services, vocational rehabilitation, etc.) to facilitate optimal treatment outcomes. + Maintains current knowledge regarding local vocational/educational rehabilitation programs and assist patients with referral and access to vocational rehabilitation to enable them to remain employed, become employed or receive education. + Assesses patient awareness of advance directives; assists with accessing advance directive forms/information and facilitates discussion of advance directive wishes, if necessary, with the healthcare team and the patient's family/support persons. + In collaboration with the physician and nurse, participates in the discussion of patient DNR status in the facility to ensure patient and/or family understand and make an informed decision about their care. + Knowledgeable of and adheres to FMCNA Social Work Policy and Measuring Patient Physical and Mental Function Policy, including documentation. + Documents based on MSW interaction and interventions provided to patient and/or family. + Quality + Provides psychosocial support and/or Social Work Focused Interventions to address non-adherence, quality outcome, and quality of life concerns for all patients based on acuity level. + Participates in monthly Quality review meetings with the interdisciplinary team. Reports on quality indicators related to adherence, such as Missed and Shortened Treatments, Quality of Life Trends, and Service Recovery. + Patient Education + Assesses patient knowledge of kidney disease for barriers that may affect adherence to treatment. Works with patient, family and health care team to provide education tailored to the patient's learning style, communication barriers, and needs. + With other members of the interdisciplinary team, provides appropriate information about all treatment modalities. + Facilitates the transplant referral process and collaborates with interdisciplinary team on transplant waitlist management. + Provides ongoing education to patient/family regarding psychosocial issues related to End Stage Renal Disease (ESRD) and all support services that are available. + Reviews patient rights and responsibilities, grievance information (company and network) and other facilities policies with patient and/or the patients' representative to ensure patients' understanding of the rights and expectations of them. + Collaborates with the team on appropriate QAI activities. + Patient Admission and Continuity of Care + Reviews Patient Rights and Responsibilities, Grievance Procedure & Important Numbers Handout, FKC Non-discrimination policy, DNR Statement (if applicable) and address any immediate needs/concerns. + Understands the referral and admission process and supports the clinic in regard to the patient needs for scheduling to maximize adherence and adjustment. + The Social Worker will interview the patient to identify root causes or concerns for the discharge request, (i.e. transfer to hospice, relocation, dissatisfaction with services or staff) and share causes/concerns with operational leadership. + Insurance and Financial Assistance + Collaborates and functions as a liaison for patient with Insurance Coordinators to address issues related to insurance. + In collaboration with Insurance Coordinators, provides information and education to patients about payment to dialysis (federal, state, commercial insurance, state renal programs, AKF HIPP, and entitlement programs). + Collaborates with the Insurance Coordinator of any changes to patient state that impacts insurance i.e. transplantation, discharged, loss of coverage, or extended travel. + Refers patients to patient billing solutions (PBS) department for questions/concerns in regard to treatment related bills + Staff Related + Assists with interview process and decision to hire new personnel if requested by SW Manager/Senior Manager. + Works with the administrative support staff to maintain updated patient resource lists (e.g. maintain updated list of transportation resources). + Provides training to staff pertaining to psychosocial topics as needed. + Contributes and participates with weekly team huddles. Discusses any urgent patient issues with staff. + Adheres to work defined caseload guidelines based on state regulatory requirements. + 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. + Travel required (if multiple facilities or home visits, if applicable) **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS** **:** + Masters in Social Work + Must have state required license + Meets the applicable scope of practice board and licensure requirements in effect in the State in which they are employed **EXPERIENCE AND SKILLS** **:** + 0 - 2 years' related experience **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. The rate of pay for this position will depend on the successful candidate's work location and qualifications, including relevant education, work experience, skills, and competencies. Annual Rate: $85,000.00 - $143,000.00 Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave and potential for performance-based bonuses depending on company and individual performance. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**No Dialysis specific experience required!! Comprehensive, on-the-job training is provided!** 2049 Lynch Way Burlington, WI 53105 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. 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 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: High School diploma or G.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. All appropriate state licensure, education, and training (if any) required. Demonstrated commitment to organization culture, values, and customer service standards EXPERIENCE AND REQUIRED SKILLS: Previous patient care experience in a hospital setting or a related facility 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

+ **No on-call** + **Every other Saturday required** + **Sundays off** + **Career Advancement Program (CAP) to advance your nephrology career from novice to expert** + **10-12 hour shifts** **Clinic Hours of Operation:** + 5am to 830pm + 5am to 530pm **Clinic Location:** 5125 W. Morgan Avenue Greenfield, WI 53220 **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 1 year of Nephrology Nursing experience in the last two years as a RN. + Minimum of 9 months experience as a Registered Nurse (preferred). + Chronic/acute hemodialysis experience (preferred). **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**

**No Dialysis specific experience required!! Comprehensive, on-the-job training is provided!** 2049 Lynch Way Burlington, WI 53105 About this role: As a Patient Care Technician (PCT) at Fresenius Medical Care, you play a vital part in supporting people who entrust us with their care, their families, and your fellow care team members. You will build deep relationships with patients when they come into our clinic. How you grow or advance: Previous healthcare experience is not required to join us as a PCT. Passion for helping others, teamwork, and a desire to learn and grow are what you need to be successful. We will provide robust training and support as you kick off your career, and we will introduce you to career path options as you grow with us either as a PCT or venture into a new role such as Registered Nurse or a leadership 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, scholarships to family members, relief when natural disasters strike, and 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: As a member of the nephrology healthcare team, you will provide safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse. • Sets up, tests, and operates hemodialysis machines for patient treatments. • Obtains and documents necessary pre- and post-treatment vital signs and weight for each patient. • Evaluates vascular access pre-treatment and performs vascular access cannulation. • Evaluates intradialytic problems and provides intervention as prescribed by physician order or as directed. • Monitors patients' response to dialysis therapy. • Evaluates patient prior to termination of venous access and discontinues dialysis treatment according to established procedures. • Reports any significant information and/or change in patient condition directly to supervisor. • Enters all treatment data into the designated clinical application in an accurate and timely manner. • Collects, labels, appropriately prepares, and stores lab samples according to required laboratory specifications. • Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding area between treatments according to facility policy. • Assists other healthcare members in providing patient education. • Prepares, organizes, and efficiently uses supplies and equipment to prevent waste. EDUCATION AND LICENSES: • High school diploma or G.E.D. required. EXPERIENCE AND REQUIRED SKILLS: • Qualities and traits: dependable, compassionate, caring, supportive, collaborative, reliable. • Previous patient care experience in a hospital setting or a related facility (preferred but not required). • Continued employment is dependent on successful completion of the Fresenius Medical Care dialysis training program and successful completion of CPR certification. 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. We 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 healthcare 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. 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 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 basis lift up to 40 lbs., as high as 5 feet. There is a 2-person assist program and "material assist” devices for the heavier items. EOE, disability/veterans

**PURPOSE AND SCOPE:** Functions as part of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a Staff Registered Nurse, to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA 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 FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. Employees hired into this position will be required to obtain their nursing license and registration within the timeframe outlined in state specific regulations, or within 90 days from hire date, whichever comes sooner. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** **STAFF RELATED:** + Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. + Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. + Assesses daily patient care needs and develops appropriate patient care assignments. + Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. + Participates in staff training and orientation of new staff as assigned + Participates in all required staff meetings as scheduled. **PATIENT RELATED:** Education: + Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). + Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. + Discusses with patient, and records education related to diet/fluid and medication compliance. + Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). + Ensures transplant awareness, modality awareness, and drive catheter reduction. + Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. Dialysis Treatment: + Provides safe and effective delivery of care to patients with ESRD. + Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. + Assesses patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. + Identifies and communicates patient related issues to Team Leader or physician. + Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. + Actively participates in the pre evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. + Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. + Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. + Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. Laboratory-related: + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. + Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. + Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. + Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. + Ensures that all labs are directed and delivered to appropriate labs. + Reports alert/panic and abnormal labs results to appropriate physician. + Ensures lab results are forwarded to physicians as requested. General duties: + Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. + Maintains overall shift operation in a safe, efficient, and effective manner. + Act as a resource for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. + Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. + Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. + Oversees all documentation of patient information. + Maintains facility drug list for all required stock medications. + Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. + Ensures verification and availability of adequate emergency equipment. + Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. + Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. + Maintains appropriate recording of controlled substances as required by law. + Assists with the coordination of patient transportation if necessary. **MAINTENANCE/TECHNICAL:** + Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. + Ensures competency in the operation of all dialysis-related equipment safely and effectively. + Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. + Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. **MEDICAL RECORDS & DOCUMENTATION:** General + Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. + Ensures all appropriate patient related treatment data is entered into the Medical Information System. + Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. + Ensures and verify accuracy of Patient Care Technician documentation. Daily + Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. + Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. Monthly + Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. + Completes monthly nurses' progress note. + Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). + Reviews transplant status and follows established procedure regarding appropriate action to be taken. + Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. + Completes any long-term programs that are due. Annually + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. **OTHER:** + As a condition of continued employment, you are required to obtain and maintain any required credentials or certifications necessary for your position in an active and valid status (including renewal of such credentials or certifications prior to any expiration date). In the event that your credential or certified status changes, you must notify your supervisor immediately. + Capable of working in a challenging environment which requires the ability to handle demanding situations, multitasking, and remaining flexible to changing needs. + Maintain regular and punctual attendance. + Perform other related duties as assigned. **_Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions._** **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 and 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. up 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. + 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 accommodation can be made. **SUPERVISION:** + None **EDUCATION** **:** + Graduate of an accredited School of Nursing. + Current appropriate state Temporary Permit. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND REQUIRED SKILLS** **:** + 0 - 1 year's related experience. **ACKNOWLEDGEMENT:** I acknowledge that I have read and accepted this . I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate supervisor or my Human Resources representative. **ADDENDUM:** Managers in each state must determine if their state regulations permit employees to operate in this capacity, as well as the allowable duties and practice restrictions if permitted. Managers should consult their state-specific regulations at: ********************************************************************************************************************************************************** . For additional information please contact your Regional Education Coordinator. **EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity** **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**No Dialysis specific experience required!! Comprehensive, on-the-job training is provided!** 5409 Durand Ave Mt Pleasant, WI 53406 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. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA 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 FMCNA 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 FMC Quality Enhancement Goals (QEP). DUTIES / ACTIVITIES: CUSTOMER SERVICE: Responsible for driving the FMS culture through values and customer service standards. Accountable for outstanding customer service to all external and internal customers. Develops and maintains effective relationships through effective and timely communication. Takes initiative and action to respond resolve and follow up regarding customer service issues with all customers in a timely manner. PRINCIPAL RESPONSIBILITIES AND DUTIES PATIENT CARE: 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. Welcome assigned patients and inquire as to their well-being since their last treatment. Report any complaints or observations to the nurse supervisor. Evaluate vascular access for patency and report any unusual findings to nurse supervisor. Obtain necessary pre and post treatment vital signs and weight. Report unusual findings to nurse supervisor. Perform vascular access evaluation pre-treatment and report unusual findings to nurse supervisor. Perform vascular access cannulation and report any difficulties in cannulation or unusual findings to nurse supervisor. Perform administration of Heparin as delegated or as allowed by state law. 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 and report any unusual findings to nurse supervisor. Obtain vital signs prior to reinfusion; perform all relevant functions necessary for the discontinuation of treatment - document. Discontinue dialysis treatment according to established procedures Evaluate patient prior to termination of venous access - standing & sitting blood pressure. Obtain Hemostasis and apply appropriate dressings. Evaluate the patient for prior to discharge and report any unusual findings to nurse supervisor. 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; Sodium (Na) modeling; 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 nurse supervisor. Observe patient and conduct machine safety checks according to facility policy. Report any change or unusual findings to the nurse 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 nurse supervisor. Obtain all prescribed laboratory testing and prepare specimens for collection. MAINTENANCE/TECHNICAL: 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. Perform all required pretreatment dialysis machine alarm testing including Pressure Holding (PHT). Initiate Solution Delivery System (SDS) system. 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. CLERICAL & ADMINISTRATIVE: Complete and document ongoing participation in Continuous Quality Improvement (CQI) activities. Enters all treatment data into the designated clinical application accurately and in a timely manner. Review treatment sheets for completeness ensure nursing signatures are documented and ensure omitted entries are completed or corrected where appropriate. Prepare initial patient chart for admission and compile paperwork for appropriate placement in chart. Prepare 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. OTHER: Perform additional duties as assigned. ADDENDUM FOR PATIENT CARE TECHNICIANS WORKING IN THE HOME PROGRAMS (NOT HOME ASSIST): Assisting the HT RN: May assist HT RN on Home Visit as directed Reinforces PD / HHD education under supervision of qualified HT RN Schedules and contacts patients regarding appointments Weigh patient and obtain vital signs Collect treatment records and review for completion. Notify RN of incomplete / missing records. Cleaning and prepping treatment room; prep charts Preparing lab tubes and requisitions & assisting with lab draw days both pre and post draw (PCT certified phlebotomy or per state regulations) Clerical duties as assigned (faxing mailing to physician offices etc.) Obtain home hemo water sampling as directed by the HT RN Set-up of the home hemo machine and PD Cycler. Assist with exit site care when directed by HT RN. Warm dialysate solution when directed by the HT RN Draw dialysate solution for testing as directed by the HT RN Creates and sends patient reminders (supply inventory for order Kt/V collection bringing meds to clinic visit for review) Assembles/breaks down charts/thins charts Maintains logs as directed and applicable Inventory of Home Program Maintains par levels of home department supplies Files home patient packing slips/invoices Inventory for Patients Assists patient with supply management and contacting customer service 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 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. 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 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 Center for Medicaid/Medicare Services (CMS)-approved state and/or national certification or High School diploma or G.E.D. and must meet certification requirements within the required state or CMS timeline. All appropriate state licensure education and training (if any) required. EXPERIENCE AND REQUIRED SKILLS Previous patient care experience in a hospital setting or related facility preferred. Continued employment is dependent on successful completion of the FMCNA 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:** Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis in accordance with FMS policies, procedures, and training. Supports the FMCNA's mission, vision, values, and customer service philosophy. Supports the FMCNA 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 FMCNA Quality Enhancement Goals (QEP). Adheres to all requirements of the FMCNA Compliance Program, and FMS patient care and administrative policies. **PRINCIPAL DUTIES AND RESPONSIBILITIES:** + Directs Patient Care Technician's provision of safe and effective delivery of chronic hemodialysis therapy to patients in compliance with standards outlined in the facility policy procedure manuals, as well as regulations set forth by the corporation, state, and federal agencies. + Delegates tasks to all direct patient care staff including but not limited to LVN/LPNs, Patient Care Technicians, and Dialysis Assistants. + Assesses daily patient care needs and develops appropriate patient care assignments. + Routinely monitors patient care staff for appropriate techniques and adherence to facility policy and procedures. + Participates in staff training and orientation of new staff as assigned + Participates in all required staff meetings as scheduled. + Ensures educational needs of patients and family are met regarding End Stage Renal Disease (ESRD). + Provides ongoing education to patients regarding their renal disease, vascular access and dialysis therapy, and other related health conditions. + Discusses with patient, and records education related to diet/fluid and medication compliance. + Provides patient specific detailed education regarding adequacy measures where applicable - Online Clearance Monitoring (OLC), Adequacy Monitoring Program (AMP), Urea Kinetic Modeling (UKM). + Ensures transplant awareness, modality awareness, and drive catheter reduction. + Educates patients regarding laboratory values and the relationship to adequate dialysis therapy, compliance with treatment schedule, medications, and fluid. + Provides safe and effective delivery of care to patients with ESRD. + Accurately implements treatment prescriptions including Sodium (Na) modeling prescription, and Ultrafiltration modeling (where appropriate) to ensure stable treatment therapy as indicated. + Assesses patients' response to hemodialysis treatment therapy, making appropriate adjustments and modifications to the treatment plan as indicated by the prescribing physician. Communicates problems or concerns to the Team Leader or physician. + Identifies and communicates patient related issues to Team Leader or physician. + Initiates Initial and Annual Nursing Assessment, and ongoing evaluation and documentation of patient care needs according to FMC Policies and Procedures. + Actively participates in the pre-evaluation, initiation, monitoring, termination, access homeostasis, and post evaluation of patients receiving hemodialysis treatment therapy according to established FMC procedures. + Takes appropriate intervention for changes in patient adequacy status and troubleshooting access flow issues as identified by OLC/AMP yellow lights. + Provides, supervises (if applicable), and monitors hemodialysis access care according to established procedures. + Implements, administers, monitors, and documents patient's response to prescribed interdialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. + Ensures accurate and complete documentation by Patient Care Technician on the Hemodialysis Treatment Sheet. + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for Spectra or alternate lab. + Ensures correct labs tubes are utilized for prescribed lab specimens and that lab draw and processing procedures are performed appropriately for all lab samples. + Identifies and ensures appropriate follow-through regarding missed labs and specimens reported to be insufficient according to company policies and procedures. + Ensures all specimens are appropriately packaged according to Department of Transportation (DOT) policies and procedures relating to shipment of blood or body fluid specimens and potentially hazardous material. + Ensures that all labs are directed and delivered to appropriate labs. + Reports alert/panic and abnormal labs results to appropriate physician. + Ensures lab results are forwarded to physicians as requested. + Enforces all company approved policies and procedures, as well as regulations set forth by state and federal agencies and departments. + Maintains overall shift operation in a safe, efficient, and effective manner. + Act as a resource for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status, issues, and information. + Collaborate and communicate with physicians and other members of the healthcare team to interpret, adjust, and coordinate care provided to the patient. + Provides assistance as needed to patients regarding prescription refills according to FMCNA Policies. + Ensures all physician orders are transcribed and entered into the Medical Information system in a timely manner. + Oversees all documentation of patient information. + Maintains facility drug list for all required stock medications. + Maintains competency with all emergency operational procedures, and initiates CPR and emergency measures in the event of a cardiac and/or respiratory arrest. + Ensures verification and availability of adequate emergency equipment. + Ensures provision of appropriate vaccinations, immunizations, and annual Tuberculosis (TB) testing. + Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification if indicated. + Administers PRN medications as prescribed and completes appropriate documentation of assessment of effectiveness. + Maintains appropriate recording of controlled substances as required by law. + Assists with the coordination of patient transportation if necessary. + Ensures a clean, safe, and sanitary environment in the dialysis facility treatment area. + Ensures competency in the operation of all dialysis-related equipment safely and effectively. + Ensures all patient stations, including machines and chairs, are clean and free of blood and placed appropriately. + Ensures that all blood spills are immediately addressed according to FMCNA Bloodborne Pathogen Control Policies. + Ensures all relevant data including physician orders, lab results, vital signs and treatment parameters, and patient status are documented appropriately and entered into Medical Information System. + Ensures all appropriate patient related treatment data is entered into the Medical Information System. + Ensures all FMCNA policies regarding patient admission, transfer, and discharge are appropriately implemented. + Ensures and verify accuracy of Patient Care Technician documentation. + Reviews and ensures appropriate daily completion of Hemodialysis Treatment Sheets by all patient care staff. + Ensures that all appropriate procedures are followed regarding opening and closing procedures, inclusive of monitoring that all staff and patients have safely left the premises. + Initiates, documents, and completes ongoing Continuous Quality Improvement (CQI) activities including monthly reports. + Completes monthly nurses' progress note. + Ensures patient medical records are complete with appropriate information, documentation, and identification on each page (Addressograph label is on all chart forms). + Reviews transplant status and follows established procedure regarding appropriate action to be taken. + Completes patient care plans for new patients within the initial 30 days or any patients deemed unstable requiring monthly patient care plans. + Completes any long-term programs that are due. + Completes initial and annual Nursing History and Assessment physical. + Ensures completion of Annual Standing Order Review with each physician as required. + Performs additional 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 position provides direct patient care that regularly involves heavy lifting and 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. up 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. + 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 accommodation can be made. **SUPERVISION:** + None **EDUCATION AND REQUIRED CREDENTIALS:** + Graduate of an accredited School of Nursing. + Current appropriate state licensure. + Must meet the practice requirements in the state in which he or she is employed. **EXPERIENCE AND SKILLS** : + Minimum of one-year medical-surgical nursing experience preferred. + Hemodialysis experience preferred. + ICU experience preferred. + Successfully complete a training course in the theory and practice of hemodialysis. + Successfully complete CPR Certification. + Employees have to meet the necessary requirements of Ishihara's Color Blindness test as a condition of employment. + Provide coverage at any or all area facilities as required by management. + Icd-9 coding Training. + Nurses Technical Training. + Must meet appropriate state requirements (if any). "The rate of pay for this position will depend on the successful candidate's work location and qualifications, including relevant education, work experience, skills, and competencies. Hourly Rate: $40 - $59 Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave. **Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.** **EOE, disability/veterans**

**No Dialysis specific experience required!! Comprehensive, on-the-job training is provided!** 2925 Saemann Ave. Sheboygan, WI 53081 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. 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 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: High School diploma or G.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. All appropriate state licensure, education, and training (if any) required. Demonstrated commitment to organization culture, values, and customer service standards EXPERIENCE AND REQUIRED SKILLS: Previous patient care experience in a hospital setting or a related facility 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

**No Dialysis specific experience required!! Comprehensive, on-the-job training is provided!** No on-call Every other Saturday required Sundays off Career Advancement Program (CAP) to advance your nephrology career from novice to expert 10-12 hour shifts Clinic Hours of Operation: MWF: 5:00am-5:00pm TTS: 5:00am-5:00pm Clinic Location: 2925 Saemann Ave. Sheboygan, WI 53081 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). ACKNOWLEDGEMENT: I acknowledge that I have read and accepted this . I understand what is expected of me in this position, and I am able to perform the essential functions as outlined with or without reasonable accommodation. Furthermore, I understand that the duties and responsibilities listed in this are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. If I have any questions about duties and responsibilities not specified in this job description that I am asked to perform, I should discuss them with my immediate Supervisor or my Human Resources representative. Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans