Peabody, MA | Registered Nurse

RN - NSPG Anticoagulation Management Service


About Us:

North Shore Physicians Group (NSPG), the largest multispecialty group north of Boston, has a singular focus: the patient. We have a total of 27 locations across the North Shore, with more than 350 board-certified physicians, nurse practitioners, and other health care professionals working as one to provide exceptional care.

We are a national leader in improving care delivery, patient health and satisfaction. Through our partnership with North Shore Medical Center and our affiliation with Massachusetts General Hospital and Partners HealthCare, we offer such advances as EMRs, shared medical appointments, online access and remote patient monitoring. Our success is built on team-based practices, collaborative environments and the importance of work-life balance.

Bring your exceptional skills to our innovative practices and join us in driving medicine forward!
General Overview:

We are seeking an RN to join our growing Anticoagulation Management Service (AMS) team full-time The NSPG AMS is an outpatient, nurse-led practice providing management of outpatients requiring anticoagulation for thrombosis prevention and treatment across the continuum of care.

The focus of this position is on managing anticoagulation therapy. This involves adjusting medication (warfarin) dosage based on the INR lab result, counseling patients on a full range of issues pertaining to anticoagulation, and developing peri-operative and procedural anticoagulation management plans. We provide point of care (fingerprick) INR testing and care management for lab, home INR testing across the continuum of care. This position will involve practice at 2-3 different sites (Lynn, Salem, Peabody) and will include face to face and telephonic care management.

Major Responsibilities

  • Demonstrates an understanding of the coagulation process, the role of Vitamin K, thrombogenesis, hypercoagulable states and antithrombotic therapy.
  • Identifies cardiovascular indications for anticoagulation therapy.
  • Understands the mechanism of action of warfarin and other anticoagulants used in clinic setting.
  • Describes the impact of medications, disease states, diet and lifestyle/activity on anticoagulation therapy.
  • Understands how socioeconomic, behavioral, psychological and environmental factors impact patient compliancy and adherence to anticoagulation therapy.
  • Understands and properly uses the Point-of-Care capillary blood-testing machine.
  • Understands the meaning of prothrombin time (PT), International Normalized Ratio (INR), and International Sensitivity Index (ISI) and how they relate to each other.
  • Provides initial and ongoing education to patients regarding warfarin, other medications, health status, diet and activity level.
  • Interprets INR and adjusts warfarin dosing, using practice guidelines and clinical judgment for each patient.
  • Assesses for signs and symptoms of bleeding, thromboembolism and manages according to practice guidelines.
  • Identifies, triages or manages other medical problems through the appropriate health care provider.
  • Determines appropriate action for interrupting and/or reversing anticoagulation and/ or bridging anticoagulation, in collaboration with relevant care team providers.
  • Provides pre- and post-procedure warfarin management for patients undergoing invasive and non-invasive procedures, e.g.. cardioversion, ablation, angiography, device placement, GI and dental procedures, steroidal injections, surgery.
  • Provides transitions to and from warfarin to other anticoagulants.
  • Communicates and coordinates with other anticoagulation providers regarding mutual patients to provide care across the continuum e.g home health care, short term rehab, palliative/ hospice care.
  • Provides instructions for patients traveling or going to winter/summer homes.
  • Manages patients who perform weekly self-testing from home
  • Documents in the electronic medical record.
  • Tracks overdue or noncompliant patients with phone calls and letters, documents in INR chart and provides written update in clinic chart.
  • Resource for clinic nursing staff for any anticoagulation questions, issues, enrolling in INR Clinic, assisting with warfarin refills, providing patient education packets.
  • Resource for nurse clinicians and MD’s for hospitalized patients on warfarin.
  • Collaborates with and adjusts anticoagulation management to meet patients’ needs, i.e. rehab, MD appointments, device checks, research, work/driving issues.
  • Manages and orders all AMS clinic INR supplies.
  • Participates in continuing education pertinent to anticoagulation, maintains BLS and NSPG annual competencies/ education requirements.
  • Travel between sites.
  • Other duties as assigned.




Must be able to deliver patient focused care, to stand alone, and to work collaboratively. Strong clinical decision making skills, priority setting, written & verbal communication are essential, The NSPG AMS is a growing practice who values interpersonal savvy, humor, change resilience, learning, participation in quality improvement initiatives.



1 or more experience in outpatient anticoagulation management preferred but will consider candidates with inpatient or outpatient anticoagulation experience.



Bachelors Degree in Nursing. Certification in Anticoagulation Management from the University of Southern Indiana (online course) within 1 year of hire.



Current licensure as a registered nurse in the Commonwealth of Massachusetts

Applicants with relevant experience will be considered. Salem Hospital, a member of Mass General Brigham, is an affirmative action/equal opportunity employer. Minorities and women are strongly encouraged to apply. Pre-employment drug screening is required.

Apply Now

Katherine Melanson
Talent Acquisition Partner

Peabody, MA
With NSPG, you’ll experience:

Career advancement

Grow, learn and develop new practice innovations.

Continue your medical education.

Make academic connections and explore teaching opportunities.

Explore leadership opportunities.

Develop clinical and administrative career ladders.

A supportive practice environment

Collaborative professionals.

Patient-centered care model.

Leadership that listens and values your contributions and ideas.

Autonomy and respect for your skills and expertise.

Excellent salary and benefits.

Clinical excellence

NSPG’s MHQP Patient Experience surveys show that we perform higher than the state mean in all domains with 92% of patients indicating that they would recommend NSPG services.

Our physicians are polling in the top 75th percentile of AMGA Satisfaction metrics for almost every major category—the highest physician satisfaction scores of any medical group in the Boston region.

25th percentile in MGMA cost benchmarks and top 75th percentile in revenue benchmarks.

The North Shore area offers an excellent quality of life:
  • Communities with varied and rich histories and convenient access to museums, art, restaurants and shops.
  • Natural beauty, handsome architecture and vivid history—only 15 miles north of Boston.
  • 30 miles of gorgeous rocky coastline with breathtaking beaches and harbors.
  • World-class sailing and close proximity to the mountains and picturesque New England.
  • Easy access to a multitude of universities, colleges, and public and private schools.
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