RN Care Manager (PACE)

About the role

Habitat Health is seeking a dynamic Registered Nurse to manage and deliver direct nursing care to our participants in various settings. This role involves managing a panel of participants, conducting assessments, and collaborating with the interdisciplinary team to develop and implement care plans. The ideal candidate will have a strong background in chronic disease management and complex geriatric care.

Responsibilities

• Contribute to a center experience that participants want to spend time in, fostering a team culture that cares and creates joy.
• Continue to raise the bar by raising clinical standards and implementing changes to improve participant outcomes.
• Participate in Interdisciplinary Team (IDT) meetings, providing insights from assessments and care plan recommendations.
• Conduct face-to-face nursing assessments in various settings, including the clinic, adult day center, and participants' homes.
• Deliver personalized care based on care plans, ensuring timely and accurate administration of medications and therapeutic interventions.
• Manage complex patient discharges, transfers, and immediate post-discharge needs, coordinating with hospital and long-term care facility case managers.
• Coordinate all aspects of care delivery, including medication management, medical equipment and supplies, and specialist referrals.
• Triage in the outpatient setting, independently initiating therapies within scope of practice and collaborating with a medical provider to escalate care as needed.
• Educate participants, caregivers, and team members on how to personalize and carry out care plans.
• Aid with wound care, IVs, and other procedures within the RN scope of practice, delegating tasks to MA and LVNs as necessary.
• Remotely take after-hour calls, performing related duties as assigned.

Requirements

• Graduate of an accredited school of nursing; Bachelor of Science (BSN) preferred.
• Unencumbered Registered Nurse (RN) license required.
• Minimum 2-4 years of experience clinically caring for medically complex or older adults' population as an RN.
• Minimum 1-2 years of experience in case management.
• Strong clinical acumen in chronic disease management and complex geriatric care.
• Experience in management of clinical interventions: wound care, IVs, phlebotomy, colostomy/ileostomy care, etc.
• Proof of medical clearance for communicable diseases, including a TB test.
• Proof of all immunizations are up to date.
• Proof of current CPR/BLS certification required or requirement to obtain within 30 days of employment.
• Valid CA driver’s license, personal transportation, good driving record, and auto insurance as required by State law.

Preferred Qualifications

• Alzheimer's certification preferred.
• Case Management certification preferred.
• Bilingual: Spanish preferred.

Benefits

We offer a competitive compensation package, including medical/dental/vision insurance, short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The expected salary range for this position is $55.00 to $68.00/hour. Habitat Health is committed to the full inclusion of all qualified individuals and provides reasonable accommodations to qualified individuals with disabilities and sincerely held religious beliefs.