RN | Registered Nurse Navigator | PACE Program

Midland Care Connection

Midland Care Connection is a not-for-profit, community-based organization dedicated to helping older adults and seriously ill individuals stay independent and supported in their homes. Established in 1978, we offer a full continuum of care, including hospice, palliative care, home health, grief and loss counseling, and our signature PACE (Program of All-Inclusive Care for the Elderly) program. Our mission centers on "meeting individual needs through innovative care solutions," and we serve people across multiple counties in northeast Kansas.

The PACE (Program of All-Inclusive Care for the Elderly) program is designed to help older adults remain safely in their homes rather than entering nursing facilities. It provides complete medical care, rehabilitation, medications, transportation, social services, and supportive therapies and coordinated by an interdisciplinary care team. Participants receive personalized care plans tailored to their unique needs, along with access to a PACE center for social activities, meals, and clinical services.

By integrating medical and supportive care under one program, PACE helps seniors maintain independence, improve quality of life, and continue living in their communities with dignity.

The PACE RN Nurse Navigator serves as a key member of the interdisciplinary care team, ensuring seamless coordination and continuity of care for PACE participants receiving services outside of Midland Care facilities. This role is responsible for guiding participants through transitions across healthcare settings, collaborating with external providers, and coordinating all aspects of care to promote positive health outcomes and an exceptional participant experience.

Working in accordance with professional nursing standards, the Nurse Navigator advocates for participants, facilitates communication among care teams, and responds flexibly to changing participant needs across the continuum of care. The position also supports after-hours participant care by participating in the PACE nursing call rotation as needed.

• Current, unrestricted Registered Nurse (RN) license in the applicable state
• Graduate of an accredited school of nursing
• Minimum of two (2) years of clinical nursing experience, preferably in case management, care coordination, geriatrics, home health, hospice, or a related setting
• Knowledge of care coordination, discharge planning, and transitions of care
• Strong assessment, critical thinking, and clinical decision-making skills
• Excellent communication and interpersonal skills with the ability to collaborate effectively within an interdisciplinary team and with external healthcare providers
• Proficiency with electronic health records (EHR) and standard computer applications
• Ability to organize, prioritize, and manage multiple participants and competing responsibilities
• Valid driver's license, reliable transportation, and ability to travel to participant care settings as needed
• Ability to participate in the PACE nursing call rotation

• Bachelor's degree in Nursing (BSN)
• Previous experience in a PACE program or with the care of older adults with complex medical, functional, and psychosocial needs
• Certification in Case Management (CCM), Gerontological Nursing (RN-BC), or a related specialty
• Experience coordinating care across multiple healthcare settings, including hospitals, skilled nursing facilities, specialty clinics, and home health
• Knowledge of Medicare, Medicaid, and PACE regulations
• Bilingual or multilingual communication skills
• Experience with quality improvement initiatives and population health management

• Health insurance options for employees and dependents
• Dental, vision, and prescription drug plans
• Flexible Savings Accounts (FSA) or Health Savings Accounts (HSA), with employer contributions
• Paid Time Off (PTO), Personal and Taking Care of You Days
• Holiday pay (six holidays per year)
• 403(b) ERISA Retirement Plan, match provided
• Free group life and AD&D insurance of $20,000
• On-site education center to provide professional development and CEU credits
• Free Employee Assistance Program (EAP) for employees and dependents
• Paid monthly volunteer time at non-profit organizations
• Uniform Allowance Program

Midland Care Connection is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.