Care Transition/Program Manager Hospice

Overview

Come Join a Dynamic Team!

At Visiting Nurse Association of Ohio, we are looking for dependable, compassionate people interested in gaining experience and becoming an invaluable resource to our organization. VNA of Ohio is now hiring a Care Transition/Program Manager and your qualifications and skill set may be an ideal match for this opportunity.

The Care Transition/Program Manager for Hospice will be responsible for responding to and visiting with patients who have been identified by Medalogix as appropriate for a "goals of care" conversation or have been referred for admission to hospice. Serves as the first point of contact in the journey into hospice through explaining the philosophy of hospice care at the VNA of Cleveland.

Responsibilities

Principal Responsibilities:

• Supports organization's mission by striving for excellence in all aspects of their job with a focus on positive interpersonal relationship with co-workers

• Screen and process inquiries for admission to By the Bay Health's total care category.

• Determine patient's eligibility for hospice care.

• Make telephone contact and/or assessment visits with potential hospice patients to provide information on agency services and/or assess patient's status.

• Assist with implementation and coordination of services required for discharge of patients from hospitals into agency's program of care.

• Maintain current documentation in computerized clinical documentation system according to agency policies and procedures and applicable laws and regulations.

• Assume initial responsibility for assessing patient/family needs and consulting with attending physician and other hospice staff members.

• Admit patients, obtain informed consent(s) for service, inform patient/family of rights and responsibilities, develop plan of care and complete related documentation in accordance with agency policies and procedures.

• Provide initial instructions to primary caregivers, volunteers and employed caregivers regarding the plan of care.

• Inform the Team Leader and IDT of unusual or potentially problematic patient/family issues.

• Attend IDT conference as requested to relay information to the IDT about new patients and to ensure continuity of agency's patient care service as indicated.

• Facilitate transition of patient/family to Patient Care Team in a timely manner.

• Manage patient/family care plan and accompanying services between time of admission and transition to Nurse Case Manager as necessary.

• Adheres to the organization's policy in regards to absenteeism and appearance.

• Other duties as assigned.

Qualifications

Job Competencies & Minimum Qualifications:

• RN with Bachelor's degree in Nursing required, Master's Degree preferred

• Experience in acute care and hospice required, home health care experience preferred

• 2+ years of experience in community health nursing providing direct patient care

• Strong computer skills

• Excellent organizational and interpersonal skills with ability to supervise others

• Excellent verbal and written communication skills

EEOC

VNA Health Group provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.