Home Hospice RN Case Manager-Lake Geneva, Lyons

Advocate Health•Burlington, WI

27d•$38 - $57•Onsite

About The Position

This role is responsible for identifying and coordinating patient/family care to support terminally ill patients and families in all hospice settings. The Case Manager utilizes teaching, assessment, and intervention skills to provide comfort care at end of life and maximize the quality of life for the patients and families. This includes educating patients and families regarding disease processes and trajectory, disease management, hospice philosophies, signs and symptoms of decline and end of life. The role also involves continuous review of all aspects of every patient on the caseload to ensure appropriate utilization of services and adherence to hospice level of care criteria, making referrals to other team members as appropriate. The Case Manager administers medication and treatments as prescribed by the physician, leads the interdisciplinary care group (IDG) for each patient and family, and coordinates all services with the interdisciplinary team. They are responsible for entering, completing, and updating documentation in the electronic health record, providing ongoing assessment of patient response to treatments, and supervising/performing Home Health Aide and licensed practical nurse supervisory visits. The role also facilitates discharge planning and may conduct OASIS assessments and establish/update plans of care for Palliative Care patients in Wisconsin. Additionally, the position requires the use of proper body mechanics and safety techniques, and the ability to orient and mentor new staff. The incumbent must demonstrate knowledge and skills appropriate to the age of the patients served.

Requirements

Registered Nurse license issued by the state in which the team member practices
Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) needs to be obtained upon hire unless department leader has determined it is not required
Driver license issued by the state of Wisconsin, or Driver license issued by the state of Illinois
Completion of an accredited or approved program in Nursing
Typically requires 1-2 years of experience in nursing that includes experiences in home health, hospice, medical/surgical, long term care, emergency care/ICU or oncology or similar related experience
Competent in the principles of deformity prevention, normal range of motion, body mechanics and body alignment; and fundamental principles of human behavior and an understanding of the effects of stress upon individuals and groups.
Excellent awareness and perception skills, for the purpose of assessing a patient's needs, concerns and to recognize changes in their health condition.
Excellent communication and interpersonal skills.
Excellent decision making and critical thinking skills, with the ability to work independently and make sound judgments.
Excellent prioritization and organizational skills.
Must possess and provide proof of valid Driver License and a registered, function car with adequate insurance coverage.

Responsibilities

Identifying and coordinating patient/family care to support terminally ill patients and families in all hospice settings.
Utilizing teaching, assessment, and intervention skills to provide comfort care at end of life and maximize the quality of life for patients and families.
Educating patients and families regarding disease processes and trajectory, disease management, hospice philosophies, signs and symptoms of decline and end of life.
Updating the primary physician as indicated and according to agency, accreditation, state and federal requirements.
Continuously reviewing all aspects of every patient on the caseload to include appropriate utilization of services and ensuring appropriate hospice level of care criteria are met.
Making referrals to other team members as appropriate.
Administering medication and treatments as prescribed by the physician.
Leading the interdisciplinary care group (IDG) specific to each patient and family on their caseload.
Working within the IDG to develop, revise, and implement the patient’s Plan of Care.
Coordinating all services and collaborating with members of the interdisciplinary team to provide consistent patient care.
Arranging for and/or recommending equipment, medical supplies and other necessary items and services as indicated.
Entering, completing and updating documentation in the electronic health record as required according to agency/department standards and policies, accreditation, state and federal guidelines.
Accurately recording the patient’s experience with a combination of assessments and narrative.
Providing on-going assessment of patient response to treatments, medications and teaching while making appropriate changes in interventions and follow-up to meet patient needs.
Updating and revising POC as indicated with supportive documentation to changes.
Communicating problems and changes in condition to physicians, supervisor and other members of the IDG.
Entering verbal orders from the physician or APN into the Electronic Health Record.
Supervising and performing Home Health Aide and licensed practical nurse supervisory visits according to agency standards.
Instructing paraprofessional staff on a timely basis and in accordance with agency, state and federal regulations.
Facilitating the discharge planning process according to agency standards and utilizing interagency/system and community resources to assure continuity of care after discharge.
WI ONLY: May conduct OASIS assessments for Palliative Care patient and establish and update the plan of care.
May conduct hospice initial and comprehensive assessments and establish and update the plan of care.
Ensuring continued skilled nursing/home bound criteria are met.
Initiating appropriate preventive and rehabilitative nursing procedures.
Utilizing proper body mechanics, assistive devices and safety techniques when performing various patient positioning/repositioning and transporting duties, which require lifting, and pushing/pulling.
Orienting and mentoring new staff as requested.
Demonstrating knowledge and skills necessary to provide care appropriate to the age of the patients served.
Demonstrating knowledge of the principles of growth and development over the life span and possessing the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the departmental policies and procedures.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program