Hospice Nurse Field Case Manager Bronx

TITLE: Spanish Field  RN  

HOURS:  M-F days exempt - no overtime

FLEXIBILITY : Must be flexible

DUTIES :  80 % field and 20% office (one day in the office - 5 visits per day)

Will be conducting the initial visit and revisits of patients. and UAS
working predominantly in (90%) Brooklyn with either Manhattan or Queens coverage in the office they will follow up with patients, assess care plans, and complete documentation.and turn in paperwork.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The Registered Nurse (RN) works under the supervision of the RN Supervisor and is responsible for the complete care of all assigned clients within the scope of the State Registered Nurse Practice Act and the policies and procedures of the organization.

The RN is responsible and accountable for making decisions and providing care according to New York Department of Health (DOH) regulations, Human Resources Administration (HRA), MCO, and MLTC guidelines.

Additionally, the RN is responsible for the coordination of care for clients by interacting and collaborating with other members of the Homecare team to optimize patient outcomes, patient satisfaction, and healthcare goals. Specific duties and responsibilities include:

Coordination of resources and services for assigned caseload based on client’s needs and health conditions, working with the clients, their families, physicians, care providers, internal resources, and external partners. This must be accomplished during the initial assessment and on an ongoing basis thereafter based on re-assessment and change in clients’ needs

Complete comprehensive client assessments to implement the best plan of care for clients; schedule and successfully engage in home visits within appropriate time frames as required by HRA and/or DOH of case referrals to complete assigned assessments

Implement the Plan of Care by ongoing assessment, planning, coordination, counseling, teaching, and supervision

Complete and maintain accurate, complete, and timely documentation reflecting the assessment, examination, diagnosis, prognosis, Plan of Care, education intervention, and evaluation according to Office of the Medical Inspector General (OMIG), DOH, agency, and other regulatory requirements for assigned cases

Deliver ongoing assessment, teaching, and training to patients/caregivers that preserves and protects patient autonomy, dignity, rights, values, and benefits using evidence-based nursing practice

Make recommendations regarding the continuation, modification, or termination of home care services and document them in patient records accordingly. Follow-up with appropriate agency and/ or MD regarding recommendations for service changes;

Notify emergency services of acute changes in the patient’s condition

Respond to emergencies and/or crises as required

Initiate appropriate preventive and rehabilitative nursing referrals as needed

Supervise the care provided by Home Health Aides; assign duties to aides based on the client’s needs

Maintains a cooperative relationship among healthcare teams

Cooperate with other agencies providing nursing or related services to provide continuity of care and implement a comprehensive care plan

Conduct in-service training classes for Home Health Aides, if needed - currently they have someone in place to do this.

Assist leadership with achieving organization goals, improving the quality of patient care outcomes, and patient satisfaction. Participate in quality assessment/performance improvement initiatives and meetings

Provide nursing care under RB Homecare policies, practices, procedures, and Standards of Nursing Practice, which may require standing, stooping, sitting, crouching, bending, and stretching to deliver patient care

Other related duties and special projects, as assigned

QUALIFICATIONS : RN, 1 year homecare required, car, DL, BLS, Bilingual Spanish required

Nursing License and current registration to practice as a registered professional nurse in New York State required

A minimum of two (2) years of experience in home health care preferred

Basic Cardiac Life Support certificate

Demonstrated comprehensive knowledge of healthcare practices based on a minimum of three years of relevant experience in the field

Demonstrated experience working with certified home health agencies strongly preferred

Ability to act with integrity, professionalism, and confidentiality

Ability to work independently and collaborate with a team

Strong organizational skills and detail-oriented

Willing to travel throughout the city to client’s homes

Excellent verbal and written communication skills combined with tact and good analytic judgment; must be able to effectively communicate with all levels of staff in the organization

Ability to demonstrate caring behaviors toward patients, family, and other caregivers

Ability to understand the concepts of institutional and structural racism and bias and their impact on underserved and underrepresented communities

Demonstrated commitment/passion for serving the elderly and/or supporting communities who have experienced systemic oppression and/or bias (i.e., people of color, LGBTQ+ people, immigrants, justice-involved persons, etc.)