Field RN Case Manager - Care at Home

Halifax Health•Port Orange, FL

About The Position

The Field RN Case Manager coordinates and implements the overall plan of care for assigned patients in various hospice settings to support the best possible quality of life. The role provides nursing care to terminally ill patients, educates patients and families, completes regulatory nursing requirements, assesses and documents patient status, manages symptoms, and develops a comprehensive Interdisciplinary Plan of Care. The nurse also orients new staff and participates in quality improvement activities. The position oversees care delivered by interdisciplinary team members and completes hospice intake and admission activities. It requires accurate assessments and documentation, ongoing adjustment of care plans to reflect patient and family needs, and effective communication with physicians, patients, families, facilities, referral sources, coworkers, and community partners. The nurse provides hospice services as assigned around the clock, including holidays, and maintains company equipment and required professional education.

Requirements

Graduation from an accredited nursing program.
Valid Florida license to practice as a Registered Nurse.
At least 1 year of experience in Medical Surgical nursing or equivalent.
Valid driver's license and good driving record.
Ability to work within an interdisciplinary team framework and demonstrate good oral and written communication skills.
Skill in providing nursing care to pediatric, adolescent, adult, and geriatric patients.
Good interpersonal skills and the ability to cope with stress; maturity and emotional stability.
Must meet Halifax Health employment criteria.
Knowledge of clinical practice and ability to perform nursing procedures in accordance with current best-practice standards and organizational policies and procedures.
Ability to document efficiently in an electronic medical record.

Nice To Haves

Hospice experience.
Certification in Hospice/Palliative care.

Responsibilities

Coordinate and implement the overall plan of care for assigned hospice patients.
Provide nursing care to terminally ill patients, patient and family education, symptom management, and support for end-of-life care.
Complete required regulatory activities, patient assessments, and medical-record documentation.
Develop, implement, document, and revise the comprehensive interdisciplinary plan of care with input from the interdisciplinary team and attending physician.
Oversee care delivered by interdisciplinary team members and complete hospice intake and admission activities.
Communicate and maintain professional working relationships with patients, families, facility staff, referral sources, physicians, coworkers, and internal and external customers.
Maintain communication with the physician.
Identify educational needs and provide appropriate education to patients, families, and community partners.
Provide hospice services as assigned 24 hours a day, 7 days a week, including holidays.
Meet or exceed productivity standards and complete electronic medical record documentation within agency guidelines.
Maintain company-owned equipment in good working order.
Attend required hospice, end-of-life, and general staff meetings and in-services.
Meet licensure education requirements and pursue education to enhance job performance.
Participate in Quality Action Teams and other quality improvement activities as assigned.
Orient new staff.