RN - PACE-Naples

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!

• Day 1 benefits
• Mileage reimbursement
• Schedule:
  
  Monday – Friday
• Sign‑on bonus of $10,000 with a 2‑year commitment

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.

• Provides and manages direct care to patients and families as part of the Interdisciplinary Team (IDT), incorporating psychosocial, spiritual, cultural, physical and biological components, and appropriate nursing intervention and follow‑up.
• Coordinates the Plan of Care, ensuring that an individualized Plan of Care is developed that accurately reflects the patient’s evolving needs.
• Educates patient, family, caregivers and other health professionals about disease process and decline, prevention, palliative interventions, caregiving, dying process and safety practices.
• Participant visit frequency dependent on risk score/needs to be determined.
• Home visits to assess home safety, medication compliance, nutritional compliance, DME compliance and the ability to live safely in the community.
• Reports changes in the patient’s condition to appropriate members of the IDT or other health professionals.
• Participates with the IDT to evaluate hospice referrals/admissions for level of care appropriateness.
• Attends daily IDT collaboration meetings.
• Provdes concise and pertinent oral and written reports to IDT; respects and encourages input from all disciplines.
• Communicates accurately and completely to physicians, staff members, patients, families, and supervisors; utilizes positive approaches when working with others.
• Supervises patient care provided by Community Health Workers and Home Health Aides as requested.
• During times of emergencies (i.e., hurricanes, etc.), may be required to report to a location designated by the company, to ensure continuity of services. This may include reporting to work ahead of the scheduled date/time due to planned lockdown of unit and staying overnight(s) based on the duration of the emergency.
• Performs other duties as assigned.

• 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 visits 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.

• Current license as RN in the state where the employee will be working.
• Minimum of one (1) year nursing experience; hospice or hospital experience preferred.
• Employees working at PACE, certification of completion of Alzheimer’s Disease and Related Dementias Training through the Florida Department of Elder Affairs.
• Previous experience working with an EMR/EHR system.
• Mobile Driver – valid driver’s license and automobile…