PACE RN Case Manager - Citrus County

It’s inspiring to work with a company where people truly BELIEVE in what they’re
doing!

When you become part of the Chapters Health Team, you’ll realize it’s more than
a job. It’s a mission. We’re committed to providing outstanding patient care and
a high level of customer service in our communities every day. Our employees
make all the difference in our success!

Benefits day 1
Schedule-Monday-Friday-days
Mileage reimbursement

Job Profile Summary

Role

The RN, Case Manager is responsible for assessing and identifying patient/family
needs, utilizing the nursing process, coordinating the Plan of Care with the
Interdisciplinary Team (IDT), and providing clinical, palliative and supportive
care to the patient/family unit in order to keep the participant in their home
environment as long as possible.

Job Description

Qualifications

• Current license as RN in the state where the employee will be working

• Minimum of one (1) year nursing experience; hospice or hospital experience

• Employees working at PACE, certification of completion of Alzheimer's Disease

• Previous experience working with an EMR/EHR (Electronic Medical/Health Record)

• Mobile Driver - Valid driver’s license and automobile insurance per Company

• Reliable transportation to meet visit schedule

• Ability to use equipment with visual and auditory mechanisms

• Ability to effectively communicate in English (verbal and written)

• Ability to visit Participant in their homes to assessments

• Ability to perform the essential functions and physical requirements

• Active BLS for healthcare professionals from the American Heart Association or

Some locations may require

* Provides reassurance on the phone to patients and families. Assists in
finding solutions to their questions and/or recognizes the need for an in
person visit. Coordinates in person visit when needed/or requested.
* Utilizes appropriate support/expert resources or personnel to resolve complex
or difficult situations.
* Documents patient/family contact information in the EMR and communicates with
the Interdisciplinary Team (IDT).
* Completes initial and semi-annual assessment for all Company services

including, but not limited to

* Explains services to patients/families and addresses questions regarding
patient needs, fears, physical limitations, while putting the
patient/family at ease; presents services in an empathetic and
compassionate manner 
* Provides information to Physicians and other IDT members and initiates Plan
of Care to address patient’s immediate needs
* Initiates skilled nursing interventions to enhance prevention, prevent
complications, alleviate symptoms and maximize physical and emotional
comfort
* Obtains Physician orders
* Completes documentation per Company policy

* Acts as the Company representative at assigned facilities while facilitating
referrals to all service lines; works closely with referring hospitals,
physicians, facilities, patients, families, and the general public.
* Communicates frequently with other members of the IDT.
* Provides all necessary clinical communication timely using SBAR.
* Discusses any potential needs with after-hours staff.
* Develops strong relationships with case managers, physicians, etc. at
facilities.

Competencies

• Satisfactorily complete competency requirements for this position.

Responsibilities of all employees

• Represent the Company professionally at all times through care delivered

• Comply with all State, federal and local government regulations, maintaining a

• Comply with Company policies, procedures and standard practices.

• Observe the Company's health, safety and security practices.

• Maintain the confidentiality of patients, families, colleagues and other

• Use resources in a fiscally responsible manner.

• Promote the Company through participation in community and professional

• Participate proactively in improving performance at the organizational,

• Improve own professional knowledge and skill level.

• Advance electronic media skills.

• Support Company research and educational activities.

• Share expertise with co-workers both formally and informally.

• Participate in Quality Assessment and Performance Improvement activities as

Job Responsibilities

• Provides and manages direct care to patients and families as part of

• Coordinates the Plan of Care, ensuring that an individualized Plan of Care is

• Educates patient, family, caregivers and other health professionals about

• Participant visit frequency dependent on risk score/needs to be determined

• Home visits to assess home safety, medication compliance, nutritional

• Reports changes in the patient’s condition to appropriate members of the IDT

• Participates with the IDT to evaluate hospice referrals/admissions for level

• Attends daily IDT collaboration meetings

• Presents concise and pertinent oral and written reports to IDT; respects and

• Communicates accurately and completely to physicians, staff members, patients,

• Supervises patient care provided by Community Health Workers and Home Health

• During times of emergencies (i. e. Hurricanes, etc.), the RN, Case Manager may

• Performs other duties as assigned.

Physical Demands for Post Offer/Pre-Placement (The demands described below are
representative of those that must be met by an individual to perform the
essential functions of the job, with or without reasonable accommodation.):

While performing the duties of this job, the following abilities are required:
see; hear; talk; walk; use hands to finger, handle or feel.

Frequently required to: stand; sit; reach with hands/arms; lift; bend; balance.

Occasionally required to: pull; push; stoop/crouch; kneel; climb stairs.

Compensation Pay Range

$61,860.66 - $96,657.28

This position requires consent to drug and/or alcohol testing after a
conditional offer of employment is made, as well as on-going compliance with the
Drug-Free Workplace Policy.

All Chapters Health System employees performing services for Florida affiliates
are submitted through the Florida Care Provider Background Screening
Clearinghouse to verify eligibility after a conditional offer of employment is
made as well as ongoing eligibility. For more information, please visit
https://info.flclearinghouse.com/ [https://info.flclearinghouse.com/].