Case Manager/Complex Care Nurse Opportunity!

About this Role

This is an opportunity for a mission-driven team player who is passionate about delivering high quality, integrated care to frail older adults. In this role, you will be responsible for the management and delivery of direct nursing care to PACE (Program of All-inclusive Care for the Elderly) participants in a variety of settings including, but not limited to, the clinic, care center, home, virtually, SNF and beyond. You will serve as a critical member of the Interdisciplinary Team (IDT) and work collaboratively to complete assessments and drive forward participant care plans. This is a chance to join a new culture of care delivery that prioritizes quality, outcomes, teamwork, and empathy in how we personalize our model to focus on what matters most to each participant. This role will allow you to practice at the top of your license, promoting ongoing learning and development of professional expertise.

Overview

Expectations for the Role

• Serves as a critical member of the Interdisciplinary Team (IDT), contributing to insightful patient assessments, comprehensive care plans, delegation of responsibilities, and timely service determination requests
• In partnership with a medical provider, leads personalized care for a panel of participants and is the point person for the IDT to ensuring progress on a participant's plan of care
• Delivers care with other team members wherever the participant is located (home, care center, virtual, ALF, SNF) in the areas of basic primary care, medication administration, wound care, oxygen therapy, and any other clinical needs in accordance with scope of practice
• Conducts nursing assessments, inclusive of physical, psychosocial and behavioral status
• Identifies emergency situations and independently initiates therapies as needed within scope of practice
• Educates participants, caregivers and staff on how to personalize and carry out care plans and respond to situations that arise in each participant's life
• Monitors and evaluates therapeutic interventions, and recommends changes as needed to proactively improve health and wellbeing
• Provides on-call coverage when needed and scheduled

$15K Sign on Bonus included!