Population Health Nurse - Duke Primary Care Pediatrics

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

 

About Duke Primary Care

 

Pursue your passion for caring with Duke Primary Care, which offers family, adolescent, and internal medicine services as well as urgent, general pediatric, and virtual care at nearly 50 clinic locations across central North Carolina.

Duke Nursing Highlights:

 

• Duke University Health System is designated as a Magnet organization
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
• Duke University Health System has 6000 + registered nurses
• Quality of Life: Living in the Triangle!
• Relocation Assistance (based on eligibility)

 

Population Health Nurse - Duke Primary Care Pediatric

 

Duke Primary Care Pediatrics provides expert, family-centered care for children from newborns through teens. Their services include well-child and sick visits, immunizations, developmental and behavioral screenings, chronic condition management, and preventive health guidance. With convenient same-day and virtual visits, lactation support, and coordination with Duke’s pediatric specialists, these departments deliver high-quality, accessible care across multiple locations, supporting the health and well-being of every child and family.

 

Location: Hybrid

 

Schedule: Monday - Friday, 8am - 5pm

 

What you will do:

The Population Health Nurse partners with pediatric patients with complex health needs, delivering care and education through a dynamic blend of educational telehealth visits and care coordination. This role guides children and their families in managing chronic illnesses, develops and coordinates individualized care plans, and ensures connection to the right resources and support. As an integral member of an interdisciplinary team, the nurse helps families navigate care transitions, empowers them with knowledge and tools, and drives improved, patient-centered health outcomes.

• Deliver specialized nursing care, create individualized care plans, and educate patients and families while using clinical judgment and following established policies.
• Identify the educational needs of patients and caregivers related to their condition, recovery, and transition back to home and community life.
• Ensure patients have access to the right care, services, and resources, including coordination with their medical home.
• Address the whole person — medical, emotional, behavioral, psychosocial, and spiritual needs — for truly comprehensive care.
• Actively involve patients and their support systems in decision-making, using a collaborative approach to build self-management skills and encourage long-term healthy behaviors.
• Communicate and coordinate with providers and care team members to reduce gaps in care, especially during transitions like hospital-to-home.
• Set measurable goals for patients and monitor the quality and success of interventions over time.
• Use data from medical records, claims, and program reports to identify patients who need outreach, education, and additional support.
• Advocate for patients and work closely with providers to ensure care is evidence-based and aligned with national standards.
• Support quality improvement initiatives by educating providers, tracking outcomes, and helping implement best practices.
• Apply innovative population health strategies to improve health outcomes and keep care cost-effective.
• Participate in performance improvement projects, product evaluations, and clinical research to advance patient care.
• Serve as a preceptor and mentor for nursing students and new staff, providing guidance and coaching in both formal and informal settings.
• May perform home visits as needed (specific details provided by the department).
• Manage the demands of a fast-paced, high-acuity environment with professionalism and resilience.

 

What you will need:

Education