Nurse Case Manager Mid/North

Hospice of Santa Cruz County•Scotts Valley, CA

1d•Hybrid

About The Position

The Nurse Case Manager (NCM) is a member of the core interdisciplinary team responsible for the care and case management of patient/families admitted to hospice service. The NCM, in collaboration with pt/family, physician and interdisciplinary team, develops and coordinates an individualized Plan of Care (POC) that reflects pt/family goals related to Safe & Comfortable Dying, Self-Determined Life Closure and Effective Bereavement. The NCM demonstrates sensitivity and compassion for the issues involved with serving patients and families facing a terminal illness, death and bereavement; clinical competence in pain and symptom management; and fiscal responsibility in the planning and delivery of services. The Nurse Case Manager provides direct supervision for Hospice Aides and LVNs, when utilized.

Requirements

Current California RN license
Valid state driver's license and liability auto insurance
Pass OIG/GSA/SAM review and all required background checks
Degree in Nursing from an accredited college
2-5 years RN experience in hospice, oncology, medsurg, ICU, ER, skilled nursing facilities or homecare
1 year minimum of Acute care experience preferred
Previous experience working with electronic medical record charting is desirable
Hospice and/or home health experience preferred
End-of-life and pain management experience preferred
Prefer technical experience with ports, IV's, TPN, Oncology, Medsurg, ICU or Homecare and Electronic Medical Record keeping
Requires ability to effectively manage self and stress related to end-of-life/death and dying experiences.
Experience in handling emotionally charged situations in calm, respectful manner.
Has strong coping skills

Nice To Haves

Bilingual in English/Spanish encouraged but not required

Responsibilities

Recognizes the patient and family as the "unit of care" and active members in the development of the POC
Respects patient right to self-determination and acts as advocate within the context of the values and ethical standards of HSCC.
Meets pt/family where they are
Utilizes nursing process in providing primary care to pt/families
Documents all care and care planning per agency policy
Provides nursing interventions for pt/family as ordered by the physician and in accordance with the POC, safe nursing practice and the policies and procedures of HSCC
Assesses and monitors management of pain and symptoms in collaboration with patient/family, IDG and physician to achieve maximum comfort
Exercises good clinical judgment
Administers medications and treatments as ordered prn
Demonstrates the ability to articulate the parameters of hospice care and services
Demonstrates the ability to work with pt/families under stress & in crisis
Develops, manages, reviews & revises HA POC & supervises HA performance per HSCC policies & procedures
Reviews and considers patient data gathered by LVN/HHA when developing and revising the plan of care.
Instructs and supports pt/family unit re: symptom mgmt, patient care, disease process & death/dying
Participates in providing after-hours coverage to pt/family as needed
Visit frequencies are appropriate to patient status
Plans & provides care within the structure of the Conditions of Participation & the Hospice Medicare/Medi-Cal Benefit
Collaborates with IDG & Attending Physician to develop, manage, review and revise a written POC that includes identified goals, interventions and outcomes that address pt/family physical, psychosocial and spiritual goals related to Safe & Comfortable Dying, Self-Determined Life Closure and Effective Grieving
Opens, closes & revises POC per HSCC guidelines
Documents all contacts/instructions/ interventions per HSCC policies & procedures
Obtains medications, medical supplies and equipment per pt need/physician order
Demonstrates understanding of pharmacy-related policies & procedures
Assess patient's continued appropriateness for hospice care per HSCC Recertification protocols
Completes Recertification documentation in a timely and accurate manner
Exercises professional management and coordinates care between and among involved parties in home, SNF and RCFE setting
Provides concise and timely on call reports
Submits completed paperwork & time sheets within the timeframes per HSCC policies & procedures
Meets all standards and requirements as indicated by licensing and accrediting agencies
Submits verification of current employment related documents per HSCC policies, procedures and licensing agencies
Completes and submits all documentation in accordance with policies and procedures
Participates in activities that affirm, enhance and develop the highest quality standards for HSCC
Participates in developing standards for quality patient care within HSCC
Participates in Quality Assessment & Improvement activities as requested
Verbal communication is concise, organized and timely per HSCC guidelines
Completes and submits all documentation in accordance with policies and procedures
Submits verification of current RN License, ongoing TB status/tests and passes OIG/GSA/SAM checks per HSCC policies, procedures and licensing agencies
Functions as a member of the HSCC IDG maintaining open & organized communication with hospice staff, volunteers and supervisor
Functions as Nurse Case Manager for hospice pts/families in the coordination/provision of nursing services
Participates in IDG meeting per protocol to promote problem solving, care planning and learning
Maintains open, organized and timely communication with hospice staff / volunteers
Works collaboratively with IDG to develop common goals to meet the needs of the patient and family
Participates in special projects as requested
Performs other related job duties as assigned by Supervisor
Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, and all other regulatory/compliance requirements are understood and followed
Submits verification of current RN license
Ensures TB/FIT checks are completed in a timely manner; at least annually