Integrated Care Nurse Case Manager

Job Description

Job Description

More than a nursing job, this is a position with a higher purpose - where you impact people's lives on a personal, human level.

As a Navian Hawaii nurse, you will guide patients and their family on their journey, delivering comfort and support with a caring heart, replacing fear with hope, helping them find the beauty and joy in every moment, and providing each person with the kindness and dignity they deserve.

Position Summary :

The Integrated Care Nurse Case Manager (NCM) has the primary responsibility of supporting patients and families on Navian Hawaii's Integrated Care Program.

The NCM will report to the Director of Integrated Care and work closely with the Interdisciplinary Groups for the program.

Primary Responsibilities :

Directly provide in-home support to patients, families, and palliative care team of community-based Physicians and Nurse Practitioners.

Also provide telehealth (video and audio) support when appropriate.

• Provide telehealth patient assessment prior to initial visit and between subsequent visits
• Assess patient's physical and mental health including the patient's reaction to illnesses and treatment regimens.
• Provide home visits and telehealth monitoring needed in support of the Integrated Care team.
• Monitor patient acuity to ensure that the patient is receiving the right care at the right time and in the right place.
• Identify and coordinate the needs of chronically ill patients and families while supporting the clinicians to help them operate as efficiently as possible.
• Record and report the results of the nursing assessment in the electronic medical record system.
• Collaborate with other health care providers to develop the appropriate patient and family-centered nursing plan of care for the patient and the family.
• Ensures the implementation of the nursing plan of care is coordinated.
• Implement the treatment and pharmaceutical regimen prescribed by any person authorized by State law to prescribe the regimen.
• Provide teaching and counseling about the patient's health, disease progression, symptom management.
• Report and record the plan for care, nursing care given, and the patient's response to that care.
• Providing for the maintenance of safe and effective nursing care, whether rendered directly or indirectly (by unlicensed staff, patients and families).
• Facilitates Advance Care Planning discussions.

Knowledge and Skills Requirements :

• Ability to exercise sound, independent judgment in planning and providing care. Flexible and organized in planning.
• Skilled in providing holistic nursing care to patients and their families. Ability to identify and provide for the psychosocial needs of caregivers in concert with the other members of the Interdisciplinary Team.
• Demonstrate skill / expertise in pain and symptom management.
• Good physical and emotional health.
• Ability to learn electronic medical records systems.
• Current TB clearance.
• Valid driver's license and use of personal, insured, registered vehicle meeting Hawaii safety standards.
• Ability to set priorities, research, problem-solve and make independent decisions with minimal supervision by using logic to identify key facts, explore alternatives, and propose quality solutions within the scope of the job.
• Must be able to multi-task with the ability to meet multiple deadlines and possess strong organizational, planning and follow-through skills.
• Excellent written and verbal communication skills as well as the ability to communicate clearly, concisely and effectively with all levels of individuals.

Experience and Educational Requirements :

• A current Hawaii license, in good standing, as a registered nurse. BSN preferred.
• At least two years clinical experience in hospice and / or home health nursing preferred.

Why Navian Hawaii?

• Consistent M-F schedule so weekends belong to you
• Team-oriented, locally run nonprofit where every voice is heard
• Competitive pay with an excellent benefits package
• Flexible organization that supports positive work / life balance

All offers of employment at Navian Hawaii are contingent on a candidate's successful completion of certain requirements which include :

• A legally compliant background check
• Drug Screen & Physical Exam
• TB Clearance
• Valid Auto Registration, Safety Inspection, and Insurance
• Navian Hawaii has also adopted a policy requiring all associates to be fully vaccinated against COVID-19, subject to limited exemptions based on medical conditions or sincerely held religious beliefs.
11 days ago