About the position
Presbyterian Complete Care is seeking a dedicated and skilled Registered Nurse (RN) with Hospice, Home Health or Complete Care experience. This onsite role at our Presbyterian El Camino location plays a vital part in ensuring the success of remote patient monitoring. In this role you will be managing clinical escalations, evaluating preventative interventions, and maintaining billing accuracy through staff training on best practices. It involves assisting with system setup from a clinical perspective and troubleshooting technical issues to ensure seamless operations. The position requires close collaboration with the Vital Tech vendor, overseeing supply management, and conducting clinical screenings for Complete Care and SMART referrals. Additionally, it includes presenting complex patient cases for team input, proactively recruiting Complete Care patients, and promoting the program across external PHS initiatives. With responsibilities extending to staff training on remote monitoring processes and serving as a backup for triage and PAC-P Remote Monitoring, this role is instrumental in optimizing patient care, fostering program growth, and ensuring operational efficiency. Occasionally, acute in-person home visits may be required, along with handling special projects as assigned.
Responsibilities
- Demonstrates nursing care management of patients as evidence by assessments that are complete, timely, and appropriate of physical, mental, psychological/social (behavioral), functional, financial, treatment, resource and spiritual needs of patients.
- Analysis that defines problems that are capable of correction through home healthcare and hospice interventions and are prioritized in development of care plan.
- Intervenes consistently with orders and changes interventions with orders to meet changes in patient need.
- Evaluates each visit the effectiveness of interventions and the patients response to intervention.
- Provide direct patient care by assessing patient for care needs, resources to meet needs and developing a home care or hospice plan of care in conjunction with physician.
- Coordinates implementation of the plan of care through a multidisciplinary home care or hospice team, community resources and the physician.
- Ensures plan of care is followed and that documentation complies with regulation.
- Maintains a department productivity standard for visits and caseload management.
- Demonstrates professional accountability for self-scheduling patient case load with appropriate frequency and duration, and concurrently updates schedule throughout the day as needed so that ongoing patient needs can be met.
- Assure patients on case load are notified timely of their visits and of any unplanned schedule changes accommodating, when possible, patient preferences for time of day.
- Precepts newly hired nurses, and students and serves as a resource person and professional role model as needed.
- Maintain communication with the multidisciplinary team and assures that orders for necessary care plan changes are obtained and assures that changes are communicated timely to the team.
- Initiates documentation in the home and completely records all care delivery so that receiving staff have record of care delivered by the end of each day which includes admissions.
- Demonstrates proficiency and competency in interventions (treatments) required through day to day practice and annual competency testing.
- Delegate or assign aspects of patient care to health care team members commensurate with their validated competency to perform the task.
- Be professionally responsible for current nursing research, current nursing standards, home care or hospice philosophy in order to maintain quality.
- Be responsible for clinical supervision of licensed and non-licensed assistive personnel.
- Participates in agency continuous quality improvement activities as required.
- Assume other leadership roles as required by the department.
- Responsible for weekend and holiday coverage and evening call for agency and patient home visits as required on a rotating basis.
- Assure clinical outcomes are met and sustained.
- Performs other functions as required.
Requirements
- Associate Degree in Nursing
- State of New Mexico or Compact State Nursing License
- BLS certification REQUIRED at time of hire
- ACLS
- PALS
- Minimum one year acute care experience within the last 3 years required; hospice, home health care or complete care experience preferred
- Current Drivers License and Auto Insurance
Benefits
- Access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.
- Educational and career development options, including tuition and certification reimbursement, scholarship opportunities.
- Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern).
- Shift differentials for nights and weekends.
- Differentials for higher education, certifications and various lead roles.
- Malpractice liability insurance.
- Loan forgiveness through the New Mexico Higher Education Department.
- EPIC electronic charting system.
