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Skills Checklists

Before you can begin applying for NurseChoice assignments, you need to complete a skills checklist. Required by hospitals, this mandatory form highlights your skills, proficiencies and experience in your specialty. The quickest and easiest way to complete your skills checklist is online. Just select your specialty from the list below, enter the necessary information on the form and click to submit. Once we receive your completed skills checklist you will be one step closer to finding a rewarding travel assignment that meets your needs.

Healthcare Leadership Competencies Assessment

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This profile is for use by healthcare professionals in this discipline and specialty.  It will not be a determining factor for the program.
Please enter your full legal name as it appears on your Social Security Card.
First Name* Middle Name Last Name*
Last 4 of Social Security Number*
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E-Mail Address* Phone Number*
1. No theory and/or experience
2. Limited experience/need supervision and/or support
3. Experienced/minimal support needed to perform
4. Proficient/can perform independently
1 2 3 4
Organizational structure and relationship
Build collaborative relationships
Develop and maintain medical staff relationships
Provide internal customer service
Practice and value shared decision making
1 2 3 4
Sensitive to what is correct behavior when communicating with diverse cultures, internal, and external
Communicate organizational mission, vision, objectives, and priorities
Prepare and deliver business communications, including meeting agendas, presentations, business reports, and project communications plans
Present results of data analysis to decision makers
Provide and receive constructive feedback
1 2 3 4
Mediation, negotiation, and dispute resolution techniques
Team building techniques
Create, participate in, and lead teams
Facilitate group dynamics, process, meetings, and discussions
1 2 3 4
Leadership styles/techniques
Potential impacts and consequences of decision making
Establish a compelling organizational vision and goals
Hold self and others accountable for organizational goal attainment
Promote and manage change
Promote continuous organization learning/improvement
1 2 3 4
Managed care models, structures, and environment
Levels of healthcare along the continuum of care
Evidence-based management practice
The interrelationships among access, quality, cost, resource allocation, accountability, and community
The patient experience (e.g., cultural differences, expectations)
Healthcare technological research and advancements
Organization and delivery of healthcare
Regulatory and administrative environment in which the organization functions
1 2 3 4
Ability to analyze and evaluate information to support a decision or recommendation
Collect and analyze data from internal and external sources relevant to each situation
Techniques for business plan development, implementation, and assessment
The functions of organizational policies and procedures
Promote and apply problem-solving philosophies
Demonstrate critical thinking and analysis
Systems thinking
Facilities planning
ACHE Fellow Status
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Exp. Date 
Nurse Executive
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Nurse Executive, Advanced
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Other: Specify 
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Other: Specify 
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Healthcare Leadership Competencies Assessment, version 1

I attest that the information I have given is true and accurate to the best of my knowledge and that I am the individual completing this form. I hereby authorize the Company to release this Skills Checklist to the Client facilities in relation to consideration of employment as a Healthcare Professional with those facilities.

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