Hospice RN Case Manager

Responsibilities

• Identify and coordinate care for terminally ill patients and families in all hospice settings, with a minimum of patient/family contact every 15 days as needed.
• Educate patients and families regarding disease processes, management, hospice philosophies, and signs and symptoms of decline; update the primary physician per agency, accreditation, state and federal requirements.
• Continuously review all aspects of each patient’s caseload to ensure appropriate utilization of services and that hospice level-of-care criteria are met; make referrals to team members as appropriate.
• Administer medication and treatments prescribed by the physician.
• Lead the interdisciplinary care group (IDG) for each patient and family, developing, revising and implementing the patient’s Plan of Care; coordinate services and collaborate with team members.
• Arrange for and recommend necessary equipment, medical supplies and other items as indicated.
• Enter, complete and update documentation in the electronic health record in accordance with agency, department and regulatory standards.
• Provide ongoing assessment of patient response to treatments, medications and teaching; update the Plan of Care and communicate changes to the medical team.
• Enter verbal orders from the physician or APN into the Electronic Health Record.
• Supervise Home Health Aide and licensed practical nurse visits per agency standards; instruct paraprofessional staff timely and in compliance with regulations.
• Facilitate discharge planning per agency standards and utilize community resources for continuity of care.
• Conduct OASIS assessments for palliative care patients and hospice initial and comprehensive assessments as required, ensuring skilled nursing/home‑bound criteria are met.
• Utilize proper body mechanics, assistive devices, and safety techniques when performing patient positioning, repositioning, and transporting duties.
• Mentor new staff when requested.
• Demonstrate knowledge and skills necessary for age‑appropriate patient care, assessing data reflective of each patient’s status and interpreting information to meet their specific needs.

• Registered Nurse license issued by the state in which the team member practices.
• Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) obtained upon hire unless otherwise determined.
• Valid driver’s license issued by the Division of Motor Vehicles.

• Completion of an accredited or approved program in Nursing.

• Typically 1–2 years of nursing experience, including home health, hospice, medical/surgical, long‑term care, emergency care/ICU, oncology, or similar related experience.

• Competence in the principles of deformity prevention, normal range of motion, body mechanics, body alignment, and fundamental human behavior principles.
• Excellent awareness and perception skills for assessing patient needs, concerns, and recognizing changes in health conditions.
• Strong communication and interpersonal skills.
• Sound decision‑making and critical‑thinking ability, capable of working independently and making sound judgments.
• Effective prioritization and organizational skills.

• Lift up to 50 lbs. from floor to waist.
• Lift up to 20 lbs. overhead.
• Carry up to 40 lbs. a reasonable distance.
• Push or pull with 30 lbs. of force.
• Perform a sliding transfer of 150 lbs. with a second person present.
• Work safely with people of various sizes and weights and handle diverse medical conditions and physical limitations.
• Move in confined spaces, including bending, kneeling, squatting, and reaching overhead for extended periods.
• Operate all necessary equipment for the job.

• Work safely with people of various sizes and weights, including those with complex medical conditions and physical limitations.
• Maintain functional speech, vision, hearing, and touch with the ability to use fine‑hand manipulation skills.
• Remain exposed to hazards such as mechanical, electrical, chemical, blood, and bodily fluids; wear protective clothing and equipment as required.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.