RN Clinical Care Navigator- Hospice

BAYADA Home Health Care•Springfield, MO

18h•Onsite

About The Position

The Clinical Care Navigator will act as a liaison and educator to patient, families, and providers regarding the principles of hospice care, home health care, palliative care, and other care options. The Clinical Care Navigator is responsible for conducting goals of care conversations, assisting with palliative care resources, and coordinating the seamless transfer of high risk, hospice eligible patients from the hospital care setting to wherever they call home. Clinical Care Navigator also provides direct patient care to inpatient hospice patients when appropriate. Integrity Home Care + Hospice, has a special purpose to help people have a safe home life with comfort, independence, and dignity. We provide a continuum of care, including nursing, rehabilitative, therapeutic, hospice, and assistive care services to children, adults, and seniors worldwide. We specializes in holistic hospice care, ministering to the mind, body, and soul, respecting each patient's spiritual and cultural values. Our services are designed to maximize the precious time left by filling it with peace, comfort, and joy for both patients and their loved ones. Integrity Home Care +Hospice aims to provide the highest quality end-of-life care so patients can remain at home with comfort, grace, and dignity.

Requirements

Exemplifies characteristics of The BAYADA Way: compassion, excellence and reliability.
Must be a registered nurse (RN) with current licensure in MO.
Minimum one (1) year experience in hospice.
Experience in care management, care coordination, discharge planning, etc. is preferred.
Acceptable pre-employment assessment results.
Ability to read, write and effectively communicate in English.

Nice To Haves

CHPN certified preferred.

Responsibilities

Demonstrate and communicate the core values of Integrity Home Care + Hospice
Develop working knowledge of Integrity's mission, services, people, organization, policies and procedures.
Coordinate the care transition of the patient including gathering chart information.
Responsible for completing part or all the admission process for hospice eligible patients.
Collaborate with referring and/or attending physician to ensure home health and hospice eligibility.
Collaborate with referring and/or attending physician to establish the Plan of Care; facilitates care plan meetings for medically complex patient
Provide daily General Inpatient (GIP) visit services or respite care when patient resides in the hospital.
Maintain patient clinical records according to hospice and hospital policy
Assist in problem resolution with all personnel as well as families/patients/community
Provide consistency, predictability and visibility in the hospital setting.
Act as liaison between patient, families, nursing staff, care coordinators, and physician staff to ensure quality care, symptom control including pain management, and emotional support for patients with life limiting illness.
Educate providers regarding symptom management tools, comfort order entry, inpatient hospice qualifications and enrollment, inpatient and outpatient palliative care resources and education.
Partner with the sales team to establish and maintain positive working relationships with current and potential referral and payer sources to bring a greater understanding of the hospice philosophy and support patients and families that desire our care and are eligible.
Assist in case management of patients outside of the hospital when requested.
Participate in after hours on call schedule as assigned.
Participates in Interdisciplinary team (IDT) meetings when necessary for hospice and palliative care as required.
Participate in the Quality Assessment Performance Improvement (QAPI) program.
Maintain expert knowledge of available supports and services, based on client needs.