RN - Lead

Position Title: Lead Registered Nurse (RN Lead) Department: Medical Supervisor: Clinical Services Manager Supervisory Responsibilities: None – Working Lead FLSA Status: Hourly (Non-Exempt)

Summary:

The Lead Registered Nurse is a working lead who combines direct patient care with day-to-day clinical leadership, coordination, and support at an assigned Alluvion Health clinic. The RN Lead maintains an active RN patient-care assignment and serves as an accessible on-site resource for nursing and clinical staff. The position supports safe, efficient, high-quality, patient-centered care, organizational quality goals, and smooth clinic operations. Working under the direction of the Clinical Services Manager the RN Lead coordinates daily workflows, patient flow, coverage, communication, training, and routine problem-solving in partnership with providers, Registered Nurses, Medical Assistants, Patient Access Specialists, Behavioral Health staff, and other multidisciplinary colleagues. Concerns requiring administrative, personnel, provider, or higher-level clinical decisions are promptly escalated to the appropriate supervisor or leader. This role has no formal supervisory authority. It does not conduct performance evaluations, initiate corrective or disciplinary actions, approve time off, or independently manage attendance or other personnel actions. Such matters are referred to the Clinical Services Manager, as appropriate.

Essential Job Responsibilities:

1. Maintains an active RN patient-care workload and provides assessment, care, education, and nursing services within RN scope of practice and established protocols.
2. Serves as the primary on-site clinical resource and working lead; remains visible, accessible, and available to clinical staff throughout the workday.
3. Assesses daily operations and helps coordinate nursing and clinical assignments according to patient volume, provider schedules, staffing, and patient needs.
4. Helps arrange break, lunch, absence, and surge coverage; provides hands-on nursing coverage when necessary and escalates significant staffing concerns.
5. Participates in or facilitates daily huddles addressing staffing, schedules, patient flow, care needs, operational barriers, and daily priorities.
6. Provides guidance on approved workflows, standing orders, clinical procedures, medication administration, documentation, and organizational policies.
7. Assists with challenging patient-care situations and promptly involves providers, supervisors, or other clinical leaders when warranted.
8. Monitors patient flow and works with providers and clinic staff to resolve routine clinical and operational obstacles affecting access, timeliness, quality, or patient satisfaction.
9. Supports orientation, onboarding, precepting, mentoring, training, and competency development for new and existing clinical staff; provides informal coaching and real-time feedback.
10. Communicates staff performance, conduct, attendance, and employee-relations concerns to the appropriate supervisor without undertaking formal personnel actions.
11. Reinforces clinical policies and professional standards; helps implement approved workflow changes, technology, programs, and organizational initiatives.
12. Identifies, documents, and escalates patient safety, risk management, infection prevention, medication, quality, and compliance concerns through established channels.
13. Supports compliance with HIPAA/HITECH, OSHA, CLIA, applicable nursing standards, infection prevention requirements, and relevant FQHC/HRSA and quality initiatives within the role’s scope.
14. Promotes timely, accurate, and complete documentation in the electronic health record and appropriate use of clinical systems.
15. Helps monitor medications, vaccines, clinical supplies, equipment, storage, inventory, handling, and emergency readiness; communicates resource needs through established processes.
16. Supports referrals, diagnostic testing, hospital follow-up, patient education, and other established care-coordination processes within RN scope.
17. Maintains familiarity with nursing and Medical Assistant roles and workflows to promote continuity of service and cross-coverage.
18. Assists with quality improvement, patient experience, patient safety, and risk management activities; identifies opportunities for better workflow, communication, and efficiency.
19. Responds to routine patient concerns within the role and escalates unresolved or complex matters; maintains patient dignity, privacy, and confidentiality.
20. Promotes productive communication among providers, clinical staff, leadership, patients, families, and community partners; collaborates with RN Leads across locations.
21. Participates in staff meetings, committees, organizational projects, professional development, and continuing education as assigned.
22. Demonstrates clinical professionalism, sound judgment, reliability, conflict resolution, teamwork, and accountability; performs other duties as assigned within the position’s scope.

Working Lead Expectations:

This is primarily a patient-care and day-to-day clinical coordination role, not an administrative or formal supervisory position. The RN Lead is expected to balance an active patient assignment with team support, immediate coverage needs, mentoring, routine workflow problem-solving, and timely escalation to the Clinical Services Manager, provider, or other appropriate leader.

Knowledge, Skills, and Abilities:

Professional RN practice, nursing assessment, patient education, medication administration, vaccines, emergency response, and patient-centered primary care. Clinic operations, patient flow, staffing coordination, clinical workflows, training, mentoring, quality improvement, and risk management. Electronic health records, documentation, HIPAA/HITECH, OSHA, CLIA, infection prevention, safety practices, and applicable FQHC requirements. Effective verbal and written communication, teamwork, conflict resolution, critical thinking, organization, time management, and customer service. Ability to exercise sound clinical judgment, prioritize competing needs, maintain confidentiality, adapt to change, recognize scope and authority limits, and escalate concerns appropriately. Ability to work independently and collaboratively, maintain productive relationships, meet deadlines, and follow established lines of authority.

Education, Experience, and Qualifications:

Graduate of an accredited Registered Nursing program required; Bachelor of Science in Nursing (BSN) preferred. Three (3) years of nursing experience preferred; primary care or ambulatory experience preferred. Experience in a Federally Qualified Health Center preferred. Prior lead nurse, charge nurse, preceptor, or clinical resource experience preferred. Current State of Montana Registered Nurse license required. Current Basic Life Support (BLS) certification required. Current driver’s license required. Ability to pass a required criminal background check.