Diabetes Care Specialist and Education

Education, Experience or Equivalent Combination:

• Bachelor's degree in Nursing or Nutrition and/or Dietetics with 2 years of prior experience in diabetes care and education, or
• Associate's degree in nursing with 4 years of prior experience in diabetes care and education.

Licensure/ Registration/ Certification:

• Maintain a current Minnesota registered nurses' licensure or
• Dietitians require Dietetic registration (RDN) and current Licensure in the state of Minnesota (LD)
• Submission of application to the State of WI Department of Safety and Professional Services for registered nurse and/or dietitian licensure required upon hire and licensure maintained.

• Current national certification as a Certified Diabetes Care & Education Specialist (CDCES) or ability to become certified within 24 months of hire.

• Current BLS certification for health professionals through the American Heart Association or Red Cross required and maintained. On-line BLS certification is not acceptable.

Knowledge, Skills, and Abilities:

• Effective Communication: Strong verbal and written skills; able to uphold clinical standards and professional ethics per the Nurse Practice Act or Scope and Standards for Credentialed Dietetic Professionals.
• Clinical Judgment: Demonstrates critical thinking, sound decision-making, and the ability to work independently while contributing to a collaborative team environment.
• Patient-Centered Service: Provides compassionate, professional care with tact and diplomacy in interactions with patients, families, and clinic staff.
• Education & Engagement: Assesses patient education needs and communicates relevant information clearly to patients, families, and care teams.
• Organization & Resilience: Skilled in planning, prioritizing, and completing tasks efficiently while remaining calm and focused under pressure.
• Technology Proficiency: Proficient in electronic medical records and Microsoft Office (Outlook, Teams, Word, Excel); strong keyboarding skills.

Education, Experience or Equivalent Combination:

• 4 years of prior experience in diabetes care and education is preferred.

Licensure/ Registration/ Certification:

• Professional association membership in American Diabetes Association (ADA) and/or Association of Diabetes Care and Education Specialists (ADCES).

Knowledge, Skills, and Abilities:

• Familiar with Diabetes Self-Management Education and Support (DSMES), The ADCES7 Self Care Behaviors, and the ADA Standards of Care.

Essential Duties:

*Some listed duties overlap and occur at the same time as other duties; therefore, percentage totals may be over 100%

% Of Time (minimum 5% increments)

Assessment

• Effectively assesses care needs of patients and caregivers, prioritizes patient needs utilizing person-centered care; conducts a comprehensive assessment including nutrition status and Social Determinants of Health; identifies patient outcomes and develops a patient care plan; implements and continuously evaluates the care plan; ensures patients are discharged with resolved educational needs and a plan for follow-up to ensure continuity of care.
• Collects and prioritizes data in a systematic and ongoing process that involves the patient, care giver, other health care providers, and environment as appropriate.
• Analyzes and interprets assessment data including laboratory results and glucose metrics to determine appropriate treatment plan in alignment with approved protocol.
• Collaborates and communicates with the diabetes team and managing clinicians.

  • Makes recommendations to managing clinicians regarding changes in therapy according to evidenced based practices and protocols.

Planning

• Develops plan of care using an outcomes-based approach ensuring quality care.

  • Develops an individualized care plan with specific goals for patients with diabetes that address the 7 self-care behaviors for diabetes self-management.

  • Establishes a plan that provides for continuity of care.
  • Develops an individualized education plan for patients and care givers based on identified learning needs.
  • Uses evidence-based research data blended with caring and compassion, to develop the plan of care and interventions.
  • Tailors the self-management educational process to everyone based on learning barriers and specific needs (i.e., use of interpreter or simplified educational materials).
  • Provides in-depth and evidenced-based information on aspects of diabetes, including pathophysiology, medications, sick day management, glucagon, use of alcohol, food plans, hypoglycemia, pattern control, diabetes technology training, complications, and preventive follow-up care.
  • Coordinates, delivers, and delegates care that is safe, ethical, and culturally competent based on patient assessment/standards of care in a timely manner.
  • Involves the patient, caregiver, and health care team members in the evaluation process when appropriate.
  • Utilizes evidence-based interventions and treatments specific to the diagnoses as appropriate.
  • Provides comprehensive, individualized healthcare teaching, using the teach back method, to patients and caregivers.
  • Actively participates in creating and implementing improvements at the point of care to achieve clinical quality, patient experience, engagement, efficiency, and effective outcomes.
  • Evaluates the patient's progress toward the identified outcomes, recognizing that outcome attainment may vary by care setting. Collaborate with members of the care team to adjust the care plan when outcomes are not as expected or require longer-term follow-up.
  • Evaluates and documents the patient's/care givers' understanding of and response to the plan of care
  • Documents patient care and education accurately, timely, and completely in the electronic health record (EHR).
  • Reassesses, revises, and documents the plan of care based on the patient's response to treatment and interventions, recognizing that response timelines may vary across care settings. Continuously evaluates and updates the plan in collaboration with the care team to ensure alignment with the patient's evolving needs and goals.
  • Effectively coordinates and communicates with the patient, caregivers, clinicians, interpreters and interdisciplinary team to identify and mobilize appropriate resources (e.g., social services, DME, pharmacy, MTM, behavioral health, technology support) that support continuity of care. Ensures timely collaboration to align care with the patient's evolving needs across settings.
  • Serves as a resource to the interdisciplinary team in the management of diabetes and its complications. Actively participates in committee work as needed and contributes to the development of educational resources that support staff competencies, enhance patient care, and promote quality diabetes management.
  • Communicate knowledge and expertise to other health professionals via oral or written presentations.
  • Engages in community outreach, as appropriate, to connect patients with local programs and services, and to foster community partnerships that advance the mission of the organization and promote equitable, high-quality diabetes care.
  • Practices within the scope of the Minnesota Nurse Practice Act, scope of practice and/or The Scope and Standards of Practice for Credentialed Dietetic professionals and Health Partners and employer specific policy.
  • Attains and applies competency (knowledge, skills, behaviors, and judgement) that reflects current evidenced-based diabetes care/nutrition and practice.
  • Participates in educational and professional development activities and maintains required competencies.
  • Maintains professional licensure and fulfills discipline-specific continuing education requirements. Once certification through the Certification Board for Diabetes Care and Education (CBDCE) is achieved, ensures ongoing maintenance and recertification every five years.
  • Demonstrates professional and personal development related to empathy, accountability, autonomy, creativity, critical thinking, joy and pride, service and caring, learning, and stewardship.
  • Engages in self-evaluation of practice on a regular basis, identifying strengths and goals for professional development.
  • Participates and obtains formal and informal feedback regarding one's own practice from patients, peers, professional colleagues, and leaders.
  • Provides immediate and ongoing positive and constructive feedback to other team members to foster a team environment of continuous improvement.
  • Contributes to a supportive and healthy work environment.
  • Actively participates in team meetings, training, practice development, organizational and unit-based communication.
  • Utilizes quality improvement data, evidence-based practice, and research to guide decisions and to improve practice and patient outcomes

Collaboration

Teamwork:

• Demonstrates a positive, respectful attitude and fosters a supportive, inclusive environment that promotes psychological safety, teamwork, and a healthy workplace culture.
• Actively contributes to team cohesion and shared goals through open communication, mutual accountability, and solution-focused collaboration.
• Effectively shares job knowledge and participates in orientation and training of new employees.
• Maintains a helpful and positive attitude and willingness to take on new and different responsibilities as assigned by leader.

X Yes

No

Does this employee have direct patient contact?

N/A

0%

Rare

1-5%

(Up to

a 1/2 hour)

Occa

6-33%

(1/2 hour

to

3 hours)

Freq

34-66%

(3 to

5 hours)

Cont

67-100%

(5 to

8 hours)

Standing - Remaining on one's feet in an upright position at a work station without moving about.

x

Walking - Moving about on foot.

x

Sitting - Remaining in a seated position.

x

x

x

Lifting - Raising or lowering an object from one level to another (includes upward pulling).

x

Carrying - Transporting an object, usually holding it in the hands or arms, or on the shoulder.

x

x

x