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Hospice RN Nurse Case Manager
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Based on South Carolina data
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What they do
A Nurse Case Manager applies nursing expertise to coordinate a patient's medical care and provides advocacy to help them get the best and most affordable care. Develop care plans including discharge planning, coordinate delivery among providers, and teach patients and families how to follow the plan. They may also help patients navigate insurance and other healthcare bureaucracies and access related social services. May work with patients who have chronic illnesses or other complex medical needs. Works at a hospital or other healthcare facility; may follow patients throughout the span of their treatment.
$68,854 / year median in South Carolina
+0% projected growth
Job Description
Area of Responsibility:
Facilitate receiving all medical records from the patient's primary provider and specialists. Review medical records. Complete consents with patients. Enroll patients in Care Management, if they meet eligibility criteria. Initiate a Care Management Plan of Care, if the patient is eligible. Capture all diagnoses at the highest specificity by creating gaps and ensure they are accepted. Complete AWV's to be reviewed by the provider. Complete cognitive impairment screenings. Complete Social Determinants of Health (SDoH) assessments and/or screenings. Complete ACP's to be reviewed with the patient by the provider. Evaluate for home health, hospice, palliative, or consults with Your Health Specialty Division, etc. Evaluate for RPM devices, resources, or tools that may improve the patient's quality of life. Communicate and coordinate care. Reconcile prescribed and OTC medications, vitamins, supplements, herbal remedies, and other treatments. Provide post-discharge education. Evaluate for adaptive equipment and DME. Evaluate for safe environment. Evaluation of acute condition(s) or follow-up from previous visit. Appropriately and accurately document and log Care Management activities. Work in conjunction with care team to keep the patients Care Management care plans up to date. Coordinate with the patient's health care team, providers, physical and occupational therapists, home health or hospice representatives and other individuals in the patient's care plan. Facilitate visits with appropriate provider or entity. Facilitate a telehealth visit with a provider for coordination of care, when necessary. Coordinate with the patient's hospice interdisciplinary team and other individuals in the patient's care plan. Participate in IDG meetings, when necessary.Qualifications:
Must be a Registered nurse. License must be in good standing with appropriate board/issuer. A minimum of three (3) years clinical experience preferred. Experience in community settings preferred. Proven ability to effectively communicate and collaborate with interdisciplinary care teams, patients, and caregivers. Strong written and verbal skills. Basic computer knowledge. Ability to manage and demonstrate effective leadership skills. Should demonstrate good interpersonal and communication skills under all conditions and circumstances. Ability to foster a cooperative work environment. Team player with ability to manage multiple responsibilities and demonstrate sound judgment. Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working orderBenefits
- Paid Time Off (PTO)
- 401(k) Plans
- Other Retirement and Savings
- Health Insurance