RN, Case Manager (HPH Hospice)

About the 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 to keep the participant in their home environment as long as possible.

Responsibilities

• Provides and manages direct care to patients and families as part of the Interdisciplinary Team (IDT), incorporating psychosocial, spiritual, cultural, physical, and biological components.
• Coordinates the Plan of Care, ensuring an individualized Plan of Care is developed that reflects the patient’s evolving needs.
• Educates patients, families, caregivers, and other health professionals about disease processes, prevention, palliative interventions, caregiving, the dying process, and safety practices.
• Conducts home visits to assess home safety, medication compliance, nutritional compliance, DME compliance, and 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 and presents concise, pertinent oral and written reports.
• Communicates accurately and completely with physicians, staff, patients, families, and supervisors using positive approaches.
• Supervises patient care provided by Community Health Workers and Home Health Aides as requested.
• Provides reassurance and solutions to patients and families via phone, coordinating in-person visits when needed.
• Documents patient/family contact information in the EMR and communicates with the IDT.
• Completes initial and semi-annual assessments for all Company services, explaining services empathetically and addressing patient/family concerns.
• Initiates skilled nursing interventions to enhance prevention, alleviate symptoms, and maximize comfort.
• Obtains physician orders and completes documentation per Company policy.
• Acts as the Company representative at assigned facilities, facilitating referrals to all service lines.
• Develops strong relationships with case managers, physicians, and other facility staff.
• During emergencies (e.g., hurricanes), may be required to report to designated work locations to ensure continuity of services.
• Performs other duties as assigned.

Requirements

• Current RN license in the state of employment.
• Minimum of one (1) year nursing experience; hospice or hospital experience preferred.
• Certification of completion of Alzheimer’s Disease and Related Dementias Training (for employees working at PACE).
• Previous experience with an EMR/EHR system.
• Valid driver’s license, automobile insurance, and reliable transportation to meet visit schedules.
• Ability to use equipment requiring visual and auditory mechanisms.
• Effective communication in English (verbal and written).
• Ability to perform home visits and assessments.
• Ability to perform essential physical functions (lifting patients/equipment, bending, pushing/pulling, kneeling) with or without reasonable accommodation.
• Active BLS certification for healthcare professionals from the American Heart Association or Red Cross.

Physical Demands

While performing the duties of this job, the following abilities are required: see, hear, talk, walk, and use hands to finger, handle, or feel. Frequently required to stand, sit, reach with hands/arms, lift, bend, and balance. Occasionally required to pull, push, stoop/crouch, kneel, and climb stairs.

Pay

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

This position requires consent to drug and/or alcohol testing after a conditional offer of employment, as well as ongoing compliance with the Drug-Free Workplace Policy. All employees are subject to background screening through the Florida Care Provider Background Screening Clearinghouse.