RN Case Manager - Hospice - Full Time - Sonoma County

Patient Care

• Completes an initial, comprehensive, and ongoing comprehensive assessment of patient and family to determine hospice or home health needs.
• Provides a complete physical assessment and history of current and previous illness(es).
• Utilizes all elements of nursing process and as defined in the state Nurse Practice Act to provide professional nursing care.
• Achieves and evaluates patient and family/caregiver needs regularly.
• Develops and revises the care plan based on nursing diagnoses and incorporates palliative nursing actions.
• Communicates with the physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physicians’ orders as required.
• Coordinates care with community health related persons to coordinate the care plan.
• Teaches the patient and family/caregiver self-care techniques as appropriate.
• Administers medications and treatments as prescribed by the physician in the physician’s plan of care.
• Counsels the patient and family/caregiver on health care instructions.
• Assists the patient with the activities of daily living and facilitates the patient's efforts toward self-sufficiency and optional comfort care.
• Maintains current documentation on EMR system according to organization policies/procedures and applicable laws/regulations.

Communication

• Completes, maintains, and submits accurate and relevant clinical notes regarding patient’s condition and care given.
• Records pain/symptom management changes/outcomes as appropriate.
• Communicates with the physician regarding the patient’s needs and reports changes in the patient’s condition; obtains/receives physicians’ orders as required.
• Communicates with community health related persons to coordinate the care plan.
• Teaches the patient and family/caregiver self-care techniques as appropriate.
• Provides medication, diet and other instructions as ordered by the physician and recognizes and utilizes opportunities for health counseling with patients and families/caregivers.
• Works in concert with the interdisciplinary group.
• Provides and maintains a safe environment for the patient.
• Assists the patient and family/caregiver and other team members in providing continuity of care.
• Works in cooperation with the family/caregiver and hospice interdisciplinary group to meet the emotional needs of the patient and family/caregiver.
• Attends interdisciplinary group meetings.

Additional Duties

• Participates in on-call duties as defined by the on-call policy.
• Ensures that arrangements for equipment and other necessary items and services are available.
• Supervises ancillary personnel and delegates responsibilities when required.
• Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and Inservice classes.
• Fulfills the obligation of requested and/or accepted case assignments.
• Actively participates in quality assessment performance improvement teams and activities.
• Maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and Inservice classes.

Job Qualifications

• A graduate of a National League of Nursing accredited school of nursing.
• Current licensure in state of practice and current CPR certification.
• Valid California Driver’s License and proof of valid auto insurance.
• California only: May have an RN license and practiced as an RN for a minimum of one year with prior LVN experience in public health, home care, Hospice, Hospital or Skilled nursing facility.
• All States: Registered nurses shall have a minimum of (a) one (1) year of experience as a professional nurse within the last three (3) years OR (b) have a baccalaureate degree in nursing from a program accredited by the National League for Nursing and a current RN license.
• A minimum of two years’ experience, at least one of which is in public health, home care, or hospice nursing is preferred.
• Must be a licensed driver with an automobile that is insured in accordance with state and/or organization requirements and is in good working order.
• Self-directed and able to work with minimal supervision.
• Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist.
• Prolonged or considerable walking or standing.
• Able to lift, position and/or transfer patients.
• Able to lift supplies and equipment.
• Considerable reaching, stop bending, kneeling and/or crouching.
• Visual acuity and hearing to perform required nursing skills.
• The ability to sit occasionally for 1-3 hours.
• The ability to frequently stand for 3-6 hours.
• The ability to occasionally drive/ operate foot control for 1-3 hours.
• The ability to walk intermittently on level and or unlevel surface for less than 1 hour.
• The ability to intermittently bend or climb for less than 1 hour.
• The ability to occasionally twist, kneel, crouching and crawling for 1-3 hours.
• The ability to lift 50 pounds frequently for 3-6 hours.
• The ability to lift greater than 50 pounds occasionally for 1-3 hours.
• The ability to carry up to 50 pounds frequently for 3-6 hours.
• The ability to carry greater than 50 pounds occasionally for 1-3 hours.
• The ability to push up to 50 pounds frequently for 3-6 hours.
• The ability to push greater than 50 pounds occasionally for 1-3 hours.
• The ability to pull up to 50 pounds frequently for 3-6 hours.
• The ability to pull greater than 50 pounds occasionally for 1-3 hours.

Why Join Us?

• Competitive Pay
• Collaborative Culture: A dynamic and supportive team environment
• Career Growth Opportunities: Various development pathways
• Work-Life Balance: Flexible schedules to meet your needs
• Comprehensive Benefits: Medical, dental, and vision insurance
• Company-paid life insurance
• Mileage reimbursement
• Paid time off, holidays, and sick days
• Employee Assistance Program
• 401(k)
• Flexible Savings Account