Patient Care Manager (RN)

Job Summary

The Patient Care Manager (PCM) is responsible for ensuring the delivery of high quality, cost effective end of life care to hospice pt/families residing at home, SNFs or RCFEs through coordination of daily clinical operations and the supervision and support of assigned work groups providing that care. PCM ensures staffing coverage for direct contact with pts/families. PCM ensures accountability and compliance of team members in order to meet Hospice regulations and HSCC policies. The PCM is responsible for the direction and management of the interdisciplinary team. The PCM demonstrates: sensitivity and compassion for the issues involved in serving patients and families facing a terminal illness, death and bereavement; clinical expertise in pain and symptom control, understanding of regulatory compliance, management and leadership skills and fiscal responsibility in the planning and delivery of services.

Essential Responsibilities

Specific Functional Responsibilities

PATIENT CARE MANAGEMENT/INTERDISCIPLINARY FUNCTION

• Facilitates optimal interdisciplinary team process to ensure the delivery of high quality, cost effective care that maximizes patient care outcomes.
• Coordinates and supports Interdisciplinary field staff: Nurses, Social Workers, and Chaplains to promote optimal team functioning. Maintains clinical and regulatory expertise to serve as clinical and systems resource to interdisciplinary team.
• Provides clinical direction and oversight of acuity ensuring optimal clinical outcomes and regulatory compliance. Names and monitors high acuity level situations, report F/U, tracks for trends.
• Follows established protocols and ensures appropriate reporting up of issues: from IDG to Patient Care Manager, from PCM to Director of Nursing, Chief Clinical Officer and Leadership

• Directs IDG preparation and recertification review. Facilitates IDG meetings to promote patient-centered care planning in an effective/efficient manner.
• Monitors and ensures appropriate, individualized plan of care interventions and follow up to identified issues.
• Assures timely, accurate and compliant documentation in medical record, centered around a patient/family centered plan of care
• Directs, manages and ensures documentation of professional management related to high acuity symptom management & changes in level of care, discharge alive, etc.
• Assigns staff to ensure appropriate utilization in meeting departmental, interdepartmental & agency goals
• Provides triage support to pt/families and staff when assigned triage staff unavailable
• Collaborates with Director of Psychosocial Services related to team Interdisciplinary patient centered care with Social Workers and Spiritual Care team members.

MANAGEMENT

• Ensures utilization of shared resources and staffing to reflect needs of census across program functions.
• Develops systems & reports to enhance patient care and outcomes.
• Oversees patient care flow & response, priorities, assignments.
• Participates in the leadership, facilitation and documentation of department meetings as requested
• Manages/reports up appropriate clinical staff and system issues, concerns and suggestions to supervisor.
• Manages/reports up appropriate clinical issues to Director Level as appropriate, and to Chief Clinical Officer/Medical Director. Maintains collaborative partnership.
• Ensures effective communication systems with On Call, Triage, PD RNs, Medical Director and Administrative On-Call for continuity and quality of care.
• Serves as liaison to Attending Physician as needed.

QAPI/UR

• Participates in QAPI and UR monitors and activities. Ensure accountability for team based improvement in identified areas.
• Monitors assigned ancillary services for quality and compliance.
• Responds in timely manner to Unusual Occurrence, Family Survey Feedback, Incident Reports and Complaints.
• Participates in Performance Improvement Projects and assigned workgroups to support culture of improvement and accountability.

METRICS ACCOUNTABILITY

• Goals/Action Plans
• Staff productivity measures
• Team budget
• Documentation standards re: timeliness, quality and accuracy,
• Accurate and timely time log entry and verification.
• Assigned QAPI and UR
• Satisfaction scores
• As requested

SECONDARY RESPONSIBILITIES

• Participates in the on- boarding process for newly assigned staff.
• Participates in Administrative On-Call rotation.
• Participates in leadership of department meets as requested.
• Participates in Patient Care Manager and other assigned work groups, such as QAPI, Facility Committee, Medication Committee, Team Leadership, etc.
• Special Assignments or other duties as assigned.

COMPLIANCE

• Ensures all HIPAA Privacy and Security Regulations, Medicare Conditions of Participation, and all other regulatory/compliance requirements are understood and followed
• Ensures compliance with all job related State/Federal Laws
• Models compliance and educates staff as necessary

SUPERVISOR RESPONSIBILITY

• Assigned RN Case Managers, Visit RNs

Requirements

Education/Experience

• 2 years of hospice, home health, or community health experience in the last 5 years
• 3-5 years previous Supervisory/Management experience with Hospice management experience desired
• Previous experience with Electronic Medical Records highly desirable
• Understanding of hospice regulatory requirements preferred

Skills Required

• Critical thinking, good judgment, leadership, change friendly/adaptable, strong verbal and written communication skills, ability to bridge regulations with clinical practice, strong customer service, flexibility, and discernment in decision making.
• Ability to stand firm and remain committed when necessary and facilitate understanding when difficult or adverse decisions must be addressed or made.
• Qualified to provide supervision of nurses and oversight of care
• Understands and uses technology effectively

Certifications, Licenses, Registrations

• Active State of CA RN license
• Current CA drivers' license required
• CHPN within 1 year of position acceptance

Physical Demands

• Strength to lift and carry materials weighing up to 15 pounds
• Vision to read printed materials and a computer screen
• Hearing and speech to communicate in person and over the telephone