RN Advanced Illness Management (AIM) Nurse / Care Transition Coordinator

Is this exciting opportunity for you? Take a look and apply!

Job Responsibilities:

• Be responsible for the overall clinical and financial operations of the Advanced Illness Management program by mitigating futile hospitalizations and case managing patients with complex illnesses that are high risk.
• Implement and evaluate goals and objectives for advanced illness management that meet and promote high standards of quality clinical care.
• Meet growth and development targets, both clinically and financially.
• Establish and maintain standards of high-quality care and customer service in compliance with federal and state regulations and guidelines.
• May provide skilled professional nursing care to patients abiding by your scope of practices and within regulations by the State Board of Registered Nursing and company policies.
• Assess symptoms and needs and advise on basic treatment.
• Provider education or support to patient’s families and caregivers.
• Participate in advanced care planning.
• Initiate referrals so the patients receives the right care at the right time.
• Collaborate with Nurse Practitioner, PCP, and/or Medical Director to address patient needs.
• Effectively and efficiently provide referrals to other service lines/ agencies on patient’s choice.

Registered Nurse Requirements:

• Excellent leadership, interpersonal, written and verbal communication skills.
• Excellent organizational, problem solving, decision making, assertiveness, presentation and communication skills required.
• Knowledge of seriously ill patients and their families, understanding of palliative care, and the ability to apply knowledge to the special needs of palliative care patients.
• Meets mandatory continuing education requirements of Dependable Home Health and licensing board.
• Compliance with accepted professional standards and practices.
• Some travel may be required for this position.
• RN with home health and/or hospice/palliative care required.
• Bachelor’s in nursing, Business Administration, or equivalent experience and knowledge in health care operations preferred.
• Two or more years’ experience in home care or hospice (if also functioning as Clinical Nursing Supervisor for the office location). Experience could also be as a Clinical Director, Hospice Director, Director of Nursing (DON), RN Administrator, Executive Director.
• Understanding of Medicare/Medicaid, Commercial insurance billing and reimbursement, and value-based care.
• Strong communication skills.

Training/Equipment:

• Fluent competence in computer and smart phone navigation.
• Working knowledge of Microsoft Outlook, Microsoft Word, MICROSOFT Excel, and Microsoft Power Point.
• Must have and maintain reliable transportation to be used for work. Must maintain current auto insurance and a valid driver’s license.

#IND2 DHH Tuc/Nog