Registered Nurse Case Manager

Job Details:
Level: Experienced,

Job Location:

Bak - Bakersfield, CA 93305, Position Type:
Full Time, Salary Range: $55.00 - $59.00 Hourly, Job Shift: Day, Job Category:
Health Care, Who We Are

PACE by IIH is empowering senior participants to age at home with dignity through personalized, comprehensive care plans that deliver high-quality health and human services along with strong community support. Through an interdisciplinary and participant-centered model of care, PACE by IIH is committed to improving quality of life, promoting independence, and providing compassionate support tailored to the unique needs of each participant.

Our team works collaboratively to deliver innovative, community-based healthcare solutions that allow seniors to remain safely and comfortably in their homes while receiving the care and services they need to thrive.

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid sick time
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Under the direct supervision of the Clinical RN Manager for administrative and case management functions, the Registered Nurse Case Manager (RN CM) is responsible for assessing, coordinating, monitoring, and providing health care services and case management for an assigned panel of Innovative Integrated Health participants.

• Assessing participants physical and mental wellness, needs, preferences and abilities, and developing plans to improve.
• Conducting Home Care Nursing assessments to determine the nursing, personal care and equipment needs in the home, preferences and goals of the participants and actively participating in Interdisciplinary Team (IDT) meetings to develop participant care plans.
• Delivering and documenting home care nursing interventions as agreed upon in the participants’ care plans including but not limited to maintaining a healthy and safe environment, promptly and accurately responding to physician orders, and correctly administering medications and performing ordered tests and treatments.
• Provide Timely and accurate documentation of regulatory assessments required for each scheduled participant in the panel within the guidelines of CMS PACE Manual – Chapter 8.
• Must fully complete Competency requirement within allotted time prior to end of orientation or prior to direct contact with participants.
• Providing on-site supervision and instruction to Personal Care Assistants and Licensed Vocational Nurse (LVN) assigned to participants’ homes at least as frequently as specified in the Home Health Agency regulations and more often if necessary.
• Recording participants’ progress, charting referrals, and scheduling home visits
• Tracking and monitoring home care hours and scheduling.
• Remaining alert to pertinent input from other team members, participants, and caregivers and updating IDT promptly of any changes in participants’ condition or medical status.
• Following up with participants who are admitted to in the Skilled Nursing Facility (SNF) or similar level of care facilities outside of acute hospital to ensure continuity of care.
• Working with the PACE Providers and other members of the IDT to manage smooth care transitions between settings (hospitals, skilled nursing facilities, home, etc.) upon proper endorsement of the Community Liaison upon discharge from acute hospital.
• Provide health education and counseling to participants and caregivers experiencing chronic conditions and end-of-life issues.
• Participating in end-of-life care coordination and support.
• In coordination with the Marketing Team, supporting enrollment of prospective participants into the program.
• Participating in end-of-life…