RN Care Manager, PACE - Home Visits & Care Coordination

Socket.dev; Riverside (CA); On-site; USD 90,000 - 115,000; Full time

Job summary

Neighborhood Healthcare PACE is seeking a Registered Nurse Care Manager to deliver comprehensive care coordination for seniors in Riverside County. The role entails patient assessments, coordinating care plans with the interdisciplinary team, and providing nursing services onsite at the PACE clinic.

The RN will support hospital discharge transitions, supervise home-based care, and educate participants and families on medications and safety, ensuring high-quality, patient-centered care.

Qualifications

• RN license in good standing.
• Experience in care coordination for PACE or similar programs.
• Ability to conduct home visits and comprehensive assessments.
• Strong documentation and compliance with regulations.

Responsibilities

• Conduct initial assessments and home visits to evaluate environment and needs.
• Coordinate semiannual assessments with IDT and participants' homes as needed.
• Document activities with participants, families, and providers per PACE policies.
• Implement and monitor care plans and nursing orders.
• Provide RN clinical coverage in the PACE clinic and triage when needed.
• Educate participants and families on nursing care and home medication administration.
• Collaborate with IDT to develop and adjust plans of care.
• Monitor participant outcomes and maintain safety and well-being.

Skills

RN (Registered Nurse)

Care coordination

Documentation

Patient education

Home visits

Emergency/triage

Interdisciplinary teamwork

Education

Registered Nurse (RN) license

Job description

Neighborhood Healthcare PACE is seeking a Registered Nurse Care Manager to deliver comprehensive care coordination for seniors in Riverside County. The role entails patient assessments, coordinating care plans with the interdisciplinary team, and providing nursing services onsite at the PACE clinic.

The RN will support hospital discharge transitions, supervise home-based care, and educate participants and families on medications and safety, ensuring high-quality, patient-centered care.