RN Care Coordinator/Clinical Care RN

Senior Care Partners PACE•Portage, MI

14d

About The Position

The P rogram of A ll-Inclusive C are for the E lderly (PACE) offers a variety of services, with many of them provided onsite at a PACE Center. PACE is an alternative to nursing home care and – through an interdisciplinary care team (IDT) of physicians, nurse practitioners, nurses, social workers, therapists, van drivers, and aides – coordinates and provides preventive, primary, acute, and long-term care services, so older individuals can continue living in the community. Why You'll Love it Here: Purpose Professional Development Paid Holidays PTO and Sick Time Internal opportunities for growth Team Support Competitive Pay Medical, Dental, Vision Insurance Life insurance 403(b) Retirement Savings Employee Assistance And MORE! Registered Nurse Care Coordinator/Clinical Care Registered Nurse Primary Purpose Provides direct nursing care to participants, utilizing excellent critical thinking skills. This role works independently in the application of advanced nursing knowledge and skills and can manage complex clinical situations. Collaboration with both licensed and non-licensed personnel. This role currently combines the responsibilities of two positions. As the organization grows, these duties are expected to transition into two separate roles.

Requirements

Bachelor’s degree preferred in Science of Nursing; Associate degree required
RN–Nursing Diploma or Degree from accredited School of Nursing or University
Well-developed ability to show discretion and maintain confidentiality
Strong communication skills, both written and verbal
Minimum of one year of experience working with the frail, elderly, or long-term care population
Must possess an unencumbered license to practice as a Registered Nurse in the State of Michigan
Possess current CPR certification by AHA or willingness and able to obtain as offered by Senior Care Partners PACE
Demonstrates our core values of compassion, integrity, teamwork, and excellence
Support of Senior Care Partners PACE philosophy
Must provide exceptional customer service in support of all staff, external partners, and participants
Must possess the ability to make independent decisions when circumstances warrant such action
Must possess the ability to plan, organize, develop, implement, and interpret Senior Care Partners PACE goals, objectives, policies, and procedures
Must be able to maintain confidentiality regarding sensitive and private information
Must have reliable transportation and be able to travel between centers as needed; current valid Michigan driver’s license and current valid vehicle insurance required
Must have reliable transportation, current valid Michigan driver’s license and car insurance
Must be 18 years of age or older
Must be fully vaccinated, or willing to be fully vaccinated against the following communicable diseases: Influenza, MMR, Varicella, Tdap/Td, Covid-19, and Hepatitis B

Nice To Haves

Minimum of one year home care experience is preferred
Minimum of one year wound care experience preferred

Responsibilities

In Home Assessments
Care Plan development
Hospitalization prevention
Triaging emergent situations and able to remain independent in the application of advanced nursing knowledge
Monitoring acute and chronic medical conditions in coordination with Primary Care Providers (PCPs)
Utilizing care plans independently to provide clinic and home-based direct care
Administers treatments, procedures and medications as prescribed to participants
Routine monitoring of acute and chronic medical conditions following the participants’ goals of care
Performs wound care and treatments as prescribed in the participants plan of care
Medication review and administration, immunizations, routine monitoring of acute and chronic medical conditions, conducting initial and periodic assessments.
Performs advanced nursing assessments using critical thinking skills.
Administers treatments/procedures/medications and other care as prescribed and according to patient care standards, identifies emergency situations and independently initiates advanced therapy
Performs assessments and actively participates in development of care plan
Makes home visits on a regular basis to provide care and treatment as ordered by the PCP. This may include wound care, lab draws, nurse assessments, medication management/set up and other nursing tasks
Performs on-call needs and determines immediate needs for participant as needed
Works beyond normal working hours and on weekends and holidays, as necessary
Must complete all required education and file requirements on time
Documents in the participant’s medical record as required by policy
Must care, support, and collaborate with everyone involved in the participant’s care including staff and the participant’s family using the participant centered care model.
Keeps the leader informed of problems or issues
Performs other duties as assigned