RN Hospice Case Manager Bronx

PMHNP ACT - Manhattan (some occasional Bronx +Brooklyn)

The ACT clinician is a core member of a multidisciplinary, community-based team providing intensive, wraparound services to adults with serious and persistent mental illness, often with co-occurring substance use disorders and complex medical needs. Services are delivered primarily in the community, where clients live and spend time.

The ACT model emphasizes outreach, continuity of care, crisis intervention, and recovery-oriented treatment for individuals with histories of homelessness, trauma, incarceration, and repeated psychiatric hospitalizations. The role requires strong collaboration, flexibility, and cultural humility in serving diverse and historically marginalized populations.

DUTIES:

Conduct comprehensive psychiatric, nursing, and/or psychosocial assessments in community settings.

Provide ongoing clinical monitoring of mental health symptoms, medication adherence, and overall functioning.

Administer, monitor, and support prescribed psychotropic medications in coordination with the psychiatric provider.

Deliver crisis intervention services and support de-escalation during psychiatric or behavioral emergencies.

Participate in daily team meetings, case conferences, treatment planning, and high-risk reviews.

Collaborate closely with ACT team members including psychiatry, social work, substance use counselors, and peer specialists.

Monitor clients’ physical health conditions and coordinate care with primary care and specialty providers.

Support care transitions including hospital discharges, shelter placements, and housing stability.

Coordinate with community partners such as hospitals, shelters, housing providers, criminal justice systems, and outreach teams.

Maintain timely and accurate clinical documentation in the Electronic Health Record (EHR) in compliance with regulatory and funding requirements.

Assist clients with appointment coordination, benefits navigation, and engagement in treatment.

Participate in quality improvement initiatives, evidence-based practice implementation, and program development as needed.

QUALIFICATION:  PMHNP, DEA Board Certification either with appropriate experience or a strong desire to work in this rewarding setting. New graduates are welcome to apply. Bi-lingual Spanish highly desirable.

Board certification and relevant experience required

Three years of experience working with individuals who have mental illness and/or co-occurring substance use disorders.

Experienced in working within culturally diverse environments and knowledgeable about various evidence-based models and theories related to psychoeducation, motivational interviewing, mental illness, and recovery.

Highly organized, self-motivated, and proficient in computer skills.

Bilingual in Spanish is highly desired.