Registered Nurse Case Manager, Hospice

Registered Nurse Case Manager, Hospice

Regular Full-Time Professional, Santa Barbara, CA, US

Requisition

At VNA Health, our mission is to revolutionize healthcare through compassion and innovation, ensuring every individual's well‑being is prioritized. We empower our employees to make a real difference in the lives of our patients and communities, driving positive change in healthcare.

Benefits:

• Employer sponsored dental, vision, basic life, disability, and AD&D insurance plans.
• Generous Paid Time Off (PTO) accrual from the first day of employment.
• $750 Wellness Benefit providing annual reimbursement for fitness and wellness expenses.
• Financial wellness program with matching 403(b) Retirement Plan and Healthcare and Dependent Care Flexible Spending Accounts (FSA).
• Supportive company culture promoting employee well‑being through programs like the Employee Assistance Program (EAP) and public transportation reimbursement.

The Registered Nurse Case Manager (RN CM) plans, organizes, and directs hospice services and is experienced in nursing, with emphasis on community health education. The RN CM builds from community resources to plan and direct services to meet the needs of individuals and families within their homes and communities, respecting and promoting the mission, values, and vision of VNA Health.

• Provide comprehensive case management to hospice patients.
• Complete an initial assessment of patient and family to determine hospice care needs. Provide a complete physical assessment and history of current and previous illness(es). Admit to appropriate level of service/care.
• Assess and evaluate patient status by writing and initiating a plan of care, regularly re‑evaluating patient and family/caregiver needs, and revising the plan as necessary.
• Initiate the plan of care and make necessary revisions as patient status and needs change.
• Use health assessment data to determine nursing diagnosis.
• Develop a plan of care pathway that establishes goals, based on nursing diagnosis and incorporates palliative nursing actions, including the patient and family in the planning process.
• Initiate appropriate preventive and rehabilitative nursing procedures; administer medications and treatments as prescribed by the physician in the physician’s plan of care.
• Counsel the patient and family in meeting nursing and related needs.
• Provide health care instructions to the patient as appropriate per assessment and plan.
• Assist the patient with activities of daily living and facilitate the patient’s efforts toward self‑sufficiency and optional comfort care.
• Maintain knowledge of state, federal, local, and accreditation regulations for the delivery of hospice services.
• Be accountable for financial resources and eligibility under various third‑party payor sources, Medicare and Medi‑Cal.

• Complete, maintain, and submit accurate and relevant clinical notes regarding patient’s condition.
• Communicate with the physician regarding the patient’s needs and report any changes in the patient’s condition; obtain/receive physician orders as required.
• Communicate with community health–related persons to coordinate the care plan.
• Teach the patient and family/caregiver self‑care techniques as appropriate. Provide medication, diet, and other instructions as ordered by the physician and recognize and utilize opportunities for health counseling with patients and families/caregivers.
• Work in concert with other hospice interdisciplinary team members.
• Provide and maintain a safe environment for the patient.
• Assist the patient and family/caregiver and other team members in providing continuity of care.
• Work in cooperation with the family/caregiver and hospice interdisciplinary team members to meet the emotional needs of the patient and family/caregiver.
• Maintain working knowledge of state, federal, local, and accreditation regulations in order to provide hospice services to community clients.

• Meet daily average productivity standards set by the agency.
• Participate in on‑call and weekend duties as defined by the agency policies.
• Participate in quality management activities.
• Ensure that…