RN - Case Manager-PACE Program Float

Chapters Health System; Fort Myers (FL); On-site; USD 62,000 - 97,000; Full time

Benefits offered by this job

Mileage reimbursement

Benefits day 1

Job summary

Chapters Health System in Florida is seeking an RN Case Manager to assess patient and family needs, coordinate the Plan of Care with the Interdisciplinary Team, and provide clinical, palliative and supportive care to keep patients in their home environment. You will perform home visits, document in the EMR, collaborate with physicians and IDT, and ensure timely communication.

A valid RN license, 1 year hospice or hospital experience, and a driver's license are required.

Qualifications

• Current RN license in the state of employment.
• Minimum of 1 year nursing experience in hospice or hospital setting.
• Experience with EMR/EHR systems.
• Valid drivers license and auto insurance as per company policy.
• Ability to communicate effectively in English (verbal and written).
• Ability to perform home visits and lift or move patients/equipment.

Responsibilities

• Assess and identify patient/family needs and coordinate the Plan of Care with the IDT.
• Provide clinical, palliative and supportive care to patients in home settings.
• Maintain documentation in the EMR and SBAR communications.
• Collaborate with physicians, IDT members and facilities to coordinate care.
• Attend daily IDT meetings and deliver concise reports.
• Respond to emergencies and perform duties during disasters as needed.

Skills

RN License

Hospice or hospital experience

EMR/EHR experience

Valid drivers license

English communication

Tools

EMR/EHR system

Job description

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing! When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success! Benefits day 1 Mileage reimbursement Schedule: Monday-Friday-days

Job Profile Summary

Role: The RN, Case Manager is responsible for assessing and identifying patient/family needs, utilizing the nursing process, coordinating the Plan of Care with the Interdisciplinary Team (IDT), and providing clinical, palliative and supportive care to the patient/family unit in order to keep the participant in their home environment as long as possible.

Job Description

Qualifications:

• Current license as RN in the state where the employee will be working
• Minimum of one (1) year nursing experience in hospice or hospital experience preferred - Employees working at PACE, certification of completion of Alzheimer's Disease and Related Dementias Training through the Florida Department of Elder Affairs
• Previous experience working with an EMR/EHR (Electronic Medical/Health Record) system
• Mobile Driver - Valid driver’s license and automobile insurance per Company policy
• Reliable transportation to meet visit schedule
• Ability to use equipment with visual and auditory mechanisms
• Ability to effectively communicate in English (verbal and written)
• Ability to visit Participant in their homes to assessments
• Ability to perform the essential functions and physical requirements (including, but not limited to: lifting patients and/or equipment, bending, pushing/pulling, kneeling) of the job with or without reasonable accommodation
• Active BLS for healthcare professionals from the American Heart Association or Red Cross. Some locations may require: Provides reassurance on the phone to patients and families. Assists in finding solutions to their questions and/or recognizes the need for an in person visit. Coordinates in person visit when needed/or requested. Utilizes appropriate support/expert resources or personnel to resolve complex or difficult situations. Documents patient/family contact information in the EMR and communicates with the Interdisciplinary Team (IDT). Completes initial and semi-annual assessment for all Company services including, but not limited to: Explains services to patients/families and addresses questions regarding patient needs, fears, physical limitations, while putting the patient/family at ease; presents services in an empathetic and compassionate manner Provides information to Physicians and other IDT members and initiates Plan of Care to address patient’s immediate needs Initiates skilled nursing interventions to enhance prevention, prevent complications, alleviate symptoms and maximize physical and emotional comfort Obtains Physician orders Completes documentation per Company policy Acts as the Company representative at assigned facilities while facilitating referrals to all service lines; works closely with referring hospitals, physicians, facilities, patients, families, and the general public. Communicates frequently with other members of the IDT.
• Communicates frequently with other members of the IDT. Provides all necessary clinical communication timely using SBAR. Discusses any potential needs with after-hours staff. Develops strong relationships with case managers, physicians, etc. at facilities.
• Provides and manages direct care to patients and families as part of Interdisciplinary Team (IDT), incorporating psychosocial, spiritual, cultural, physical and biological components, and appropriate nursing intervention and follow-up.
• Coordinates the Plan of Care, ensuring that an individualized Plan of Care is developed that accurately reflects the patient’s evolving needs.
• Educates patient, family, caregivers and other health professionals about disease process and decline, prevention, palliative interventions, care giving, dying process and safety practices.
• Participant visit frequency dependent on risk score/needs to be determined
• Home visits to assess home safety, medication compliance, nutritional compliance, DME compliance- ability to live safely in the community.
• Reports changes in the patient’s condition to appropriate members of the IDT or other health professionals.
• Participates with the IDT to evaluate hospice referrals/admissions for level of care appropriateness.
• Attends daily IDT collaboration meetings.
• Present concise and pertinent oral and written reports to IDT; respects and encourages input from all disciplines.
• Communicates accurately and completely to physicians, staff members, patients, families, and supervisors; utilizes positive approaches when working with others.
• Supervises patient care provided by Community Health Workers and Home Health Aides as requested.
• During times of emergencies (i.e. Hurricanes, etc.), the RN, Case Manager may be required to report to work at a location designated by the company, to ensure continuity of services. This may include reporting to work ahead of your scheduled date/time due to planned lock down of unit, and staying overnight(s) based on duration of emergency.
• Performs other duties as assigned.

Physical Demands

• see; hear; talk; walk; use hands to finger, handle or feel.
• Frequently required to: stand; sit; reach with hands/arms; lift; bend; balance.
• Occasionally required to: pull; push; stoop/crouch; kneel; climb stairs.

Compensation

Pay Range: $61,860.66 - $96,657.28

This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy. All Chapters Health System employees performing services for Florida affiliates are submitted through the Florida Care Provider Background Screening Clearinghouse to verify eligibility after a conditional offer of employment is made as well as ongoing eligibility. For more information, please visit https://info.flclearinghouse.com/.

Choices. Education. Guidance.

As a progressive leader and premier health organization, Chapters Health System is dedicated to delivering innovative care throughout chronic illness progression and beyond. Since 1983 as a community-based, not-for-profit organization, Chapters Health has provided choices, education and guidance through its managed affiliates: Capital Caring Health, Chapters Health Foundation, Chapters Health Hospice, Chapters Health Pharmacy, Chapters Health Staffing, Cornerstone Hospice & Palliative Care, Good Shepherd Hospice, Hope Healthcare, Hospice of Okeechobee, HPH Hospice and LifePath Hospice. Chapters Health offers services throughout the Southeast and Mid-Atlantic regions of the country to improve the patient/family experience well in advance of end-of-life needs. Chapters Health and its affiliates are licensed in Alachua, Arlington, Bradford, Charlotte, Cherokee, Citrus, Cobb, Collier, Columbia, District of Columbia (all eight wards), Dixie, Fairfax, Fauquier, Fayette, Forsyth, Fulton, Gilchrist, Glades, Gwinnett, Hall, Hamilton, Hardee, Hendry, Hernando, Highlands, Hillsborough, Howard, Lafayette, Lake, Lee, Levy, Loudoun, Marion, Martin, Miami-Dade, Monroe, Montgomery, Okeechobee, Orange, Osceola, Pasco, Pinellas, Polk, Prince George’s, Prince William, Putnam, St.Lucie, Sumter, Suwannee and Union counties. Click here to view the video! All Chapters Health System employees performing services for Florida affiliates are submitted through the Florida Care Provider Background Screening Clearinghouse to verify eligibility after a conditional offer of employment is made as well as ongoing eligibility. For more information, please visit https://info.flclearinghouse.com/.

Equal Employment Opportunity Statement

It is the policy of the Organization to provide equal employment opportunities to all employees and applicants for employment. The Organization(s) complies with all civil rights laws and other federal, state and local fair employment laws that prohibit any unlawful employment practices including harassment and discrimination based on race, color, religion, gender, national origin, age, physical or mental disability, marital status, pregnancy, genetic information, status as a covered veteran, sexual orientation, or any other characteristic protected by law. Employment decisions, including hiring and promoting, are based on merit, qualifications, abilities and business needs. This policy applies to all terms and conditions of employment in accordance with applicable federal, state and local laws.