Administrative Assistant
Under the direction of the Director of Operations, the Administrative Assistant is responsible for providing administrative support to PACE Southeast Michigan.
Specific Duties and Functions:
Accurate typing ability from rough draft; prepares correspondence in final form Schedules appointments; arranges for meetings and conferences; completes travel arrangements and maintains direct reports’ business calendarsProactively review direct reports’ calendars for conflicts to make adjustments and/or seek guidance from direct report Plans and implements office practices and procedures, such as the maintenance and revision of departmental document flow and filing systemsMaintain department databases including contact information for donors, participants, caregivers, employees, elected officials, and community partners for mailings, mass emails, robo-calls, photo releases and other information tracked by the Public Affairs and Philanthropy departmentMaintains recurring and special reports and financial statements which depict department activities such as fundraising and community givingAssist with the planning and execution of fundraising, educational, grand opening, and other departmental events.Ensures the timely acknowledgement of donor gifts with thank you notesPrepares invoices for donor giftsSchedules social media posts and contributes to contentMaintains department records and files, including tracking for complianceManages and processes specified orders with outside vendors for department and from other departmentsManage and fulfill department orders, track inventoryMaintain volunteer contact informationCompile minutes from meetings and department huddlesAt the direction of the Director of Public Affairs, update center signage as neededAdheres to deadlines as established with the capability to prioritize functions as assignedOther duties as assignedSkills, Knowledge and Abilities Required:
High School diploma/GED required. Bachelor’s Degree preferredRequires 1 to 2 years of progressively responsible administrative work experienceRequires computer literacy and proficiency in Microsoft office, web-based database programs, social media with a requirement to type an average of 40-60 WPMProficiency with Outlook and schedulingAttention to detail, excellent follow-through, flexibilityRequires excellent interpersonal communication skills – both verbal and written - to effectively deal with internal team members and outside customers Read LessHOME CARE SCHEDULER
Under the direction of the PACE SE MI Center Manager; the Home Care Scheduler is responsible for assuring that high quality care is provided to participants in their homes, through a variety of measures. As a member of the IDT the HC Scheduler shares relevant information pertaining to the care delivered in the home, any area of concern, including customer service concerns. The HC Scheduler effectively guides the Home Care Aids (HCA) in the coordinated delivery of care to participants. The HC Scheduler is responsible for developing and implementing the home care assistant’s schedule for timely, effective delivery of care to participants in their home. The scheduler conducts regular review of the nursing assistant documentation records and assures that all care is provided according to the patient- centered, coordinated care plan.
SPECIFIC DUTIES AND FUNCTIONS:
Monitors and directs home care staff members in the performance of all duties. Collaborates with the home care staff as well as all members of the Interdisciplinary Team in implementing the participant's plan of care.As a member of the IDT updates the team on requests for home care services.Re-enforces PACE SEMI policies and procedures in the provision of care with all home care staff members.Reports and follows up appropriately with any unusual occurrence according to PACE SEMI policy. Reports and follows up on participant concerns appropriately and in a timely fashion, according to PACE SEMI policy.Develops and maintains schedule for home care assistants to achieve minimum productivity standards. Maintains home care assistant productivity through tracking of submitted paperwork, and schedules work accordingly. Communicates problem trends to staff members as they occur and holds staff accountable for weekly productivity.Provides ongoing communication and guidance for home care assistant field staff when problems arise. Advocates to others on behalf of the participant, and demonstrates accountability in resolving participant concerns or issues.Understands, promotes, complies with the Participant Bill of Rights; works toward achieving high levels of participant satisfaction.Participation in quality assurance activities to help identify opportunities for improvement with focus on participant care and safety. Participation in various committees and workgroups within PACE SEMI as assigned by the Center Manager.KNOWLEDGE, SKILLS AND ABILITIES:
Takes and active role in self-development through continuing education, utilizing resources within the health care system or elsewhere. Previous supervisory experience preferred or demonstration of progressive leadership responsibility is required. The ability to establish and maintain interpersonal and interdepartmental relationships.Must have one (1) year of experience with a frail or elderly population.The ability to guide and monitor home care assistants in the delivery of care.Participates in and/or facilitates QA projects resulting from data results. Read LessAdministrative Assistant
Under the direction of the Director of Operations, the Administrative Assistant is responsible for providing administrative support to PACE Southeast Michigan.
Specific Duties and Functions:
Accurate typing ability from rough draft; prepares correspondence in final form Schedules appointments; arranges for meetings and conferences; completes travel arrangements and maintains direct reports’ business calendarsProactively review direct reports’ calendars for conflicts to make adjustments and/or seek guidance from direct report Plans and implements office practices and procedures, such as the maintenance and revision of departmental document flow and filing systemsMaintain department databases including contact information for donors, participants, caregivers, employees, elected officials, and community partners for mailings, mass emails, robo-calls, photo releases and other information tracked by the Public Affairs and Philanthropy departmentMaintains recurring and special reports and financial statements which depict department activities such as fundraising and community givingAssist with the planning and execution of fundraising, educational, grand opening, and other departmental events.Ensures the timely acknowledgement of donor gifts with thank you notesPrepares invoices for donor giftsSchedules social media posts and contributes to contentMaintains department records and files, including tracking for complianceManages and processes specified orders with outside vendors for department and from other departmentsManage and fulfill department orders, track inventoryMaintain volunteer contact informationCompile minutes from meetings and department huddlesAt the direction of the Director of Public Affairs, update center signage as neededAdheres to deadlines as established with the capability to prioritize functions as assignedOther duties as assignedSkills, Knowledge and Abilities Required:
High School diploma/GED required. Bachelor’s Degree preferredRequires 1 to 2 years of progressively responsible administrative work experienceRequires computer literacy and proficiency in Microsoft office, web-based database programs, social media with a requirement to type an average of 40-60 WPMProficiency with Outlook and schedulingAttention to detail, excellent follow-through, flexibilityRequires excellent interpersonal communication skills – both verbal and written - to effectively deal with internal team members and outside customers Read LessRN CASE MANAGER
The Registered Nurse Case Manager (RNCM) of the PACE Southeast Michigan (PACE SEMI) utilizes a systematic approach to nursing practice which incorporates all aspects of the nursing process including, assessment, planning, implementation and evaluation of frail elders with complex needs. The RN demonstrates a direct relationship between nursing interventions and participant outcomes, demonstrates clinical competence and engages in effective patient teaching in areas of prevention as well as treatment. The RN effectively leads or directs licensed and non-professional nursing staff in the coordinated delivery of care to participants of the PACE Southeast Michigan program. The focus of care is one that enhances functional capacity, encouraging autonomy in all aspects of care, and assures coordination of all nursing care.
SPECIFIC DUTIES AND FUNCTIONS:
The RNCM assesses participants’ needs and plans for appropriate nursing care upon the Initial Intake Assessment as well as upon routine Re-Evaluation Assessments.The RNCM works and collaborates with the participant and the family, as well as all members of the multidisciplinary Team in developing the participant’s plan of care.The RNCM maximizes the participant’s functional capacity by encouraging autonomy in all aspects of care.The RNCM teaches, supervises and counsels the participant, or caregiver regarding nursing care needs and other related problems. The RN utilizes adult learning principles when planning for and implementing educational information to the participants, caregivers or family members.The RNCM initiates preventative and rehabilitative procedures or programs as appropriate for the participants’ care and safety.The RNCM administers medications and treatments, as ordered by the physician/NP, and monitors the participant’s response. The RN notifies the appropriate medical personnel of changes in the participant’s status.The RNCM demonstrates knowledge of the medications he/she administers and instructs the participant/family in safe administration of medication in the home. Assesses for and encourages compliance with medication regimen.The RNCM recognizes and understands the significance of abnormal test results and utilizes critical thinking skills when gathering participant data, planning for, and implementing care.The RNCM provides safe total patient care to participants with complex health problems with a focus on the individual participant and the family.The RNCM maintains all standards of nursing practice and follows hospital policies/procedures for care delivery and medication administration.The RNCM leads and monitors licensed and other professional and non-professional staff in the delivery of nursing care to the participant in the home. The RN is responsible for monthly supervision and subsequent documentation of home health aide services provided in the participant’s home.The RNCM evaluates participant outcomes and or progress toward achieving the objectives/goals of the care plan and communicates this information among other members of the Multidisciplinary Team.The RNCM collaborates with the Interdisciplinary Team to revise the plan of care based on changes in the participants’ physical or psychosocial status, and initiates actions that are consistent with the changes in status.The RNCM participates with patients, families and members of the Interdisciplinary Team to evaluate/measure the individual and group response to nursing care and teaching interventions and documents the outcomes of the problems identified at every scheduled review.The RNCM maintains accurate and timely records of participant’s functional /health status, progress toward care plan outcomes, revisions to care plans, care given, etc. All charting and documentation is performed in accordance with CSI policies/procedures. The RNCM participates in the collection and documentation of Data PACE information.The RNCM advocates to others on behalf of the participant, and demonstrates accountability in resolving participant concerns or issues.The RNCM understands, complies with and promotes the Participant Bill of Rights and assesses and works toward achieving high levels of participant satisfaction.The RNCM may provide after hours on-call medical assistance on a rotating basis, via phone triage or after hours home visits to participants as needed.Schedule requires a rotating on call shift.KNOWLEDGE, SKILLS AND ABILITIES:
Must be a Registered Nurse with current Michigan licensure, BSN preferred.The RNCM participates in annual, mandatory in-service training and screening, including but not limited to: infection control, TB testing, safety training, and BLS training.The RNCM assumes responsibility for self-development through continuing education, utilizing resources within the health care system or elsewhere; the RN promotes professional behavior and growth by serving as a role model within the health team.The RNCM must possess a current State of Michigan driver’s license and maintain an acceptable driving record.The RNCM has the ability to establish and maintain interpersonal and interdepartmental relationships.The RNCM has the ability to apply principles of adult learning in planning and implementing educational activities.The RNCM has the ability to lead and direct other licensed and non-professional nursing staff in the delivery of care.The RNCM participates in and/or facilitates Quality Assurance projects resulting from data results.The RNCM assists with the implementation of nursing research studies.The RNCM reviews current periodical literature relevant to the general practice of nursing as well as information pertaining to the PACE model of care.The RNCM ensures adherence to departmental and external standards in the provision of quality focused care by attendance at professional meetings/committees and review of national standards of practice.Must meet a standardized set of competencies (approved by CMS) after working independently.Must have one (1) year of experience with a frail or elderly population.WORKING CONDITIONS:
Works in the participant’s home which is an uncontrolled environment. May be exposed to potentially infectious materials, blood-borne disease pathogens, and hazardous waste. Must be medically cleared for communicable diseases and have all immunizations up-to-date after engaging in direct participant contactDriving is required within PACE SEMI catchment area, with possible exposure to extreme temperatures, including heat and cold. Must have reliable transportation available on a daily basis.Frequent walking, bending, lifting of forty (40) pounds or more may be needed in the performance of duties. Read LessPOSITION SUMMARY:
Under the general supervision of the Center Director the Clinical Manager is responsible for providing leadership and clinical care coordination to the center clinical teams.
SPECIFIC DUTIES AND FUNCTIONS:
Supervises and coordinates the clinical participant care and services.
Directly supervises center clinic staff, RN Case Managers, Community LPN’s, Registered Dieticians, Social workers, Rehab team, Spiritual Care and Behavioral health social workers.
Provides high quality care in accordance with federal and state regulations
Leads collaborative teamwork
Practices Models PACE SEMI Values and 10 principles
Leads Center Performance Outcomes
Assures resolve/closure of clinical care issues
In collaboration with the Center Manager, facilitates the Participant-Centered Planning meetings, as well as the Care Plan Development/Enrollment meetings, to assure consistency in care planning and service authorization for participants enrolled at PACE SEMI
Assists the Medical Director as requested in duties related to clinical and operational issues and special projects as may be required.
Communicates and collaborates with center and organizational leadership to assure consistency with practices across the organization.
Facilitates administrative, quality and performance improvement requirements, such as reports and statistical records.
Participates in and/or facilitates Quality Assurance projects resulting from data results.
Ensures adherence to departmental and external standards in the provision of quality focused care by attendance at professional meetings/committees and review of national standards of practice.
Ensures adherence to budgetary guidelines.
Hire, Payroll, Staff Scheduling & coverage
Other duties as assigned.
GENERAL REQUIREMENTS:
Bachelor’s degree Required
Registered Nursing degree preferred
At least five years of clinical long-term care experience, including one year with frail elderly population, and five years of supervisory experience.
Must have the ability to lead and direct other licensed nursing staff in the delivery of care, only acts within scope of his/her practice.
Must meet a standardized set of competencies (approval by CMS) after working independently.
Must be medically cleared for communicable diseases and have all immunizations up-to-date after engaging in direct participant contact.
Must meet Registered Nurse State Licensure requirements (be legally authorized to practice in Michigan, and only act within the scope of his/her authority to practice).
Excellent oral and written communication skills necessary; must have strong interpersonal skills.
WORKING CONDITIONS:
Ability to work under pressure, flexible, with imagination and group leadership skills.
Possible exposure to communicable disease.
Read LessCLINIC RN COORDINATOR
Under the general supervision of the Ambulatory Care Clinic Manager is responsible for operational oversite of the medical clinics. The Clinic Registered Nurse serves in the role of Clinical Coordinator responsible for ensuring the functions optimally by appropriately delegating and monitoring the activities of the Licensed Practical Nurse, Medical Assistant and Scheduling Clerks. Utilizes a systematic approach to nursing practice which incorporates all aspects of the nursing process including, assessment, planning, implementation and evaluation of PACE Participants. The Clinic RN Coordinator demonstrates a direct relationship between nursing interventions and participant outcomes, demonstrates clinical competence and engages in effective patient teaching for acute and chronic illnesses. The focus of care is one that enhances functional capacity, encourages autonomy in all aspects of care, and encourages Participant, Caregiver and Family involvement in achieving health care goals.
SPECIFIC DUTIES AND FUNCTIONS:
Collaboration with the Physician and Nurse Practitioner to ensure optimal clinical flow.Daily workflow of clinical activities and delegation of task to the clinic Licensed Practical Nurse, Medical Assistant and Scheduling Clerk.Triaging and assessment of Participants in the clinic setting and providing education resources.Supervises the LPN and Medical Assistants to ensure competency of clinical skills and task.Collaborates with Manager to ensure adherence to quality initiatives in the clinic setting and organizational.Ensures that clinical activities are documented in the Participants medical record by clinic staff daily.Ensures that documentation of clinical activities are evidence-based and adheres to standards set by quality and professional standards.Collaborates with RN Case Managers regarding care delivered to Participants in the clinic and any transitions of care, through verbal and electronic communication.Collaborates with all Interdisciplinary Team members regarding care delivered to Participants in the clinic and any transitions of care, through verbal and electronic communication.Collaborates with Nurse Educators regarding any assessed educational needs of staff and new hire competency skills compliance.GENERAL REQUIREMENTS:
BSN preferred.At least one year working with the frail elderly population. Five years of management experience preferred.Must have the ability to lead and direct staff in the delivery of care.Must be medically cleared for communicable diseases and have all immunizations up-to-date after engaging in direct participant contact. Excellent oral and written communication skills necessary; must have strong interpersonal skills. Must have the ability to understand and standardize process related to quality indicators and utilize technology to document and present data.WORKING CONDITIONS:
Ability to embody our culture traits of caring, belonging, honest, evolving, fun, excelling, and grateful. Must be flexible, with imagination and group leadership skills.Possible exposure to communicable disease.Position requires the ability to drive between locations on a daily basis as needed. Read LessPosition Summary:
The Life Enrichment Program Specialist is a key member of PACE SEMI and coordinator to our LE and care team, responsible for developing, planning, and coordinating engaging, participant-centered activities that promote the physical, emotional, cognitive, and social well-being of our senior participants. This role is ideal for someone who is creative, compassionate, and passionate about enhancing the quality of life for older adults in a structured, community-based setting.
Responsibilities:
Program Planning & Implementation. Partnering with LE Therapist to understand status, evolve to create exciting activities for centers in a standardized manner.Partner on monthly calendar development and implementation of diverse activities tailored to the interests, abilities, and cultural backgrounds of participants.With the center leadership, ensure group and one-on-one programs including music, art, games, exercise, reminiscence therapy, and intergenerational events and more are occurring to participants satisfaction.Accountable to the participant satisfaction survey results with center leadership.Incorporate therapeutic and recreational goals into daily programming to support participants’ care plans.Partner with leaders, staff, environmental, and safety officer for environmentally safe activities.Participant Engagement:
Build meaningful relationships with participants to understand their preferences and encourage active involvement.Adapt activities to accommodate varying levels of physical and cognitive ability, including those with dementia or mobility challenges.Provide emotional support and companionship to foster a warm, inclusive environment.Communication:
Work closely with nursing, social work, and rehabilitation staff to align activities with participants’ health and wellness goals.Communicate regularly with families and caregivers regarding participant engagement and progress as needed.Coordinate with volunteers, entertainers, community partners, and others to enrich programming.Documentation & Compliance:
Partner with center leadership, other appropriate leaders and staff in accordance with PACE SEMI State & CMS licensing requirements.Ensure all activities comply with safety protocols and infection control standards.Compliance of competencies and training may be required in this role and responsibilities.Education and Experience:
High school diploma or equivalent required; Associate’s or Bachelor’s degree in Therapeutic Recreation, Gerontology, or related field preferred.Minimum 1–2 years of experience working with older adults in a healthcare, senior center, or adult day care setting.Experience with dementia care and adaptive programming is highly desirable.Skills:
Strong interpersonal and communication skills.Creativity in developing meaningful and inclusive program.Ability to lead groups, motivate participation, and partner with leadership ensuring programed activities designed are executed in a timely manner across centers.Computer skills is a must.Certifications:
Certified Activity Professional (NCCAP) or Therapeutic Recreation Specialist (CTRS) required.CPR and First Aid certification required or obtainable upon hire with successful completion of less than 2 months.Working Conditions:
Active, hands-on role requiring frequent movement, lifting up to 25 lbs., and occasional assistance with mobility devices.May involve exposure to individuals with cognitive impairments or behavioral challenges.Must be able to lift up to 25 pounds or more at times.Any other duties or responsibility required as necessary by leader or leadership. Read LessCLINIC RN COORDINATOR
Under the general supervision of the Ambulatory Care Clinic Manager is responsible for operational oversite of the medical clinics. The Clinic Registered Nurse serves in the role of Clinical Coordinator responsible for ensuring the functions optimally by appropriately delegating and monitoring the activities of the Licensed Practical Nurse, Medical Assistant and Scheduling Clerks. Utilizes a systematic approach to nursing practice which incorporates all aspects of the nursing process including, assessment, planning, implementation and evaluation of PACE Participants. The Clinic RN Coordinator demonstrates a direct relationship between nursing interventions and participant outcomes, demonstrates clinical competence and engages in effective patient teaching for acute and chronic illnesses. The focus of care is one that enhances functional capacity, encourages autonomy in all aspects of care, and encourages Participant, Caregiver and Family involvement in achieving health care goals.
SPECIFIC DUTIES AND FUNCTIONS:
Collaboration with the Physician and Nurse Practitioner to ensure optimal clinical flow.Daily workflow of clinical activities and delegation of task to the clinic Licensed Practical Nurse, Medical Assistant and Scheduling Clerk.Triaging and assessment of Participants in the clinic setting and providing education resources.Supervises the LPN and Medical Assistants to ensure competency of clinical skills and task.Collaborates with Manager to ensure adherence to quality initiatives in the clinic setting and organizational.Ensures that clinical activities are documented in the Participants medical record by clinic staff daily.Ensures that documentation of clinical activities are evidence-based and adheres to standards set by quality and professional standards.Collaborates with RN Case Managers regarding care delivered to Participants in the clinic and any transitions of care, through verbal and electronic communication.Collaborates with all Interdisciplinary Team members regarding care delivered to Participants in the clinic and any transitions of care, through verbal and electronic communication.Collaborates with Nurse Educators regarding any assessed educational needs of staff and new hire competency skills compliance.GENERAL REQUIREMENTS:
BSN preferred.At least one year working with the frail elderly population. Five years of management experience preferred.Must have the ability to lead and direct staff in the delivery of care.Must be medically cleared for communicable diseases and have all immunizations up-to-date after engaging in direct participant contact. Excellent oral and written communication skills necessary; must have strong interpersonal skills. Must have the ability to understand and standardize process related to quality indicators and utilize technology to document and present data.WORKING CONDITIONS:
Ability to embody our culture traits of caring, belonging, honest, evolving, fun, excelling, and grateful. Must be flexible, with imagination and group leadership skills.Possible exposure to communicable disease.Position requires the ability to drive between locations on a daily basis as needed. Read LessRN CASE MANAGER
The Registered Nurse Case Manager (RNCM) of the PACE Southeast Michigan (PACE SEMI) utilizes a systematic approach to nursing practice which incorporates all aspects of the nursing process including, assessment, planning, implementation and evaluation of frail elders with complex needs. The RN demonstrates a direct relationship between nursing interventions and participant outcomes, demonstrates clinical competence and engages in effective patient teaching in areas of prevention as well as treatment. The RN effectively leads or directs licensed and non-professional nursing staff in the coordinated delivery of care to participants of the PACE Southeast Michigan program. The focus of care is one that enhances functional capacity, encouraging autonomy in all aspects of care, and assures coordination of all nursing care.
SPECIFIC DUTIES AND FUNCTIONS:
The RNCM assesses participants’ needs and plans for appropriate nursing care upon the Initial Intake Assessment as well as upon routine Re-Evaluation Assessments.The RNCM works and collaborates with the participant and the family, as well as all members of the multidisciplinary Team in developing the participant’s plan of care.The RNCM maximizes the participant’s functional capacity by encouraging autonomy in all aspects of care.The RNCM teaches, supervises and counsels the participant, or caregiver regarding nursing care needs and other related problems. The RN utilizes adult learning principles when planning for and implementing educational information to the participants, caregivers or family members.The RNCM initiates preventative and rehabilitative procedures or programs as appropriate for the participants’ care and safety.The RNCM administers medications and treatments, as ordered by the physician/NP, and monitors the participant’s response. The RN notifies the appropriate medical personnel of changes in the participant’s status.The RNCM demonstrates knowledge of the medications he/she administers and instructs the participant/family in safe administration of medication in the home. Assesses for and encourages compliance with medication regimen.The RNCM recognizes and understands the significance of abnormal test results and utilizes critical thinking skills when gathering participant data, planning for, and implementing care.The RNCM provides safe total patient care to participants with complex health problems with a focus on the individual participant and the family.The RNCM maintains all standards of nursing practice and follows hospital policies/procedures for care delivery and medication administration.The RNCM leads and monitors licensed and other professional and non-professional staff in the delivery of nursing care to the participant in the home. The RN is responsible for monthly supervision and subsequent documentation of home health aide services provided in the participant’s home.The RNCM evaluates participant outcomes and or progress toward achieving the objectives/goals of the care plan and communicates this information among other members of the Multidisciplinary Team.The RNCM collaborates with the Interdisciplinary Team to revise the plan of care based on changes in the participants’ physical or psychosocial status, and initiates actions that are consistent with the changes in status.The RNCM participates with patients, families and members of the Interdisciplinary Team to evaluate/measure the individual and group response to nursing care and teaching interventions and documents the outcomes of the problems identified at every scheduled review.The RNCM maintains accurate and timely records of participant’s functional /health status, progress toward care plan outcomes, revisions to care plans, care given, etc. All charting and documentation is performed in accordance with CSI policies/procedures. The RNCM participates in the collection and documentation of Data PACE information.The RNCM advocates to others on behalf of the participant, and demonstrates accountability in resolving participant concerns or issues.The RNCM understands, complies with and promotes the Participant Bill of Rights and assesses and works toward achieving high levels of participant satisfaction.The RNCM may provide after hours on-call medical assistance on a rotating basis, via phone triage or after hours home visits to participants as needed.Schedule requires a rotating on call shift.KNOWLEDGE, SKILLS AND ABILITIES:
Must be a Registered Nurse with current Michigan licensure, BSN preferred.The RNCM participates in annual, mandatory in-service training and screening, including but not limited to: infection control, TB testing, safety training, and BLS training.The RNCM assumes responsibility for self-development through continuing education, utilizing resources within the health care system or elsewhere; the RN promotes professional behavior and growth by serving as a role model within the health team.The RNCM must possess a current State of Michigan driver’s license and maintain an acceptable driving record.The RNCM has the ability to establish and maintain interpersonal and interdepartmental relationships.The RNCM has the ability to apply principles of adult learning in planning and implementing educational activities.The RNCM has the ability to lead and direct other licensed and non-professional nursing staff in the delivery of care.The RNCM participates in and/or facilitates Quality Assurance projects resulting from data results.The RNCM assists with the implementation of nursing research studies.The RNCM reviews current periodical literature relevant to the general practice of nursing as well as information pertaining to the PACE model of care.The RNCM ensures adherence to departmental and external standards in the provision of quality focused care by attendance at professional meetings/committees and review of national standards of practice.Must meet a standardized set of competencies (approved by CMS) after working independently.Must have one (1) year of experience with a frail or elderly population.WORKING CONDITIONS:
Works in the participant’s home which is an uncontrolled environment. May be exposed to potentially infectious materials, blood-borne disease pathogens, and hazardous waste. Must be medically cleared for communicable diseases and have all immunizations up-to-date after engaging in direct participant contactDriving is required within PACE SEMI catchment area, with possible exposure to extreme temperatures, including heat and cold. Must have reliable transportation available on a daily basis.Frequent walking, bending, lifting of forty (40) pounds or more may be needed in the performance of duties. Read LessRN CASE MANAGER
The Registered Nurse Case Manager (RNCM) of the PACE Southeast Michigan (PACE SEMI) utilizes a systematic approach to nursing practice which incorporates all aspects of the nursing process including, assessment, planning, implementation and evaluation of frail elders with complex needs. The RN demonstrates a direct relationship between nursing interventions and participant outcomes, demonstrates clinical competence and engages in effective patient teaching in areas of prevention as well as treatment. The RN effectively leads or directs licensed and non-professional nursing staff in the coordinated delivery of care to participants of the PACE Southeast Michigan program. The focus of care is one that enhances functional capacity, encouraging autonomy in all aspects of care, and assures coordination of all nursing care.
SPECIFIC DUTIES AND FUNCTIONS:
The RNCM assesses participants’ needs and plans for appropriate nursing care upon the Initial Intake Assessment as well as upon routine Re-Evaluation Assessments.The RNCM works and collaborates with the participant and the family, as well as all members of the multidisciplinary Team in developing the participant’s plan of care.The RNCM maximizes the participant’s functional capacity by encouraging autonomy in all aspects of care.The RNCM teaches, supervises and counsels the participant, or caregiver regarding nursing care needs and other related problems. The RN utilizes adult learning principles when planning for and implementing educational information to the participants, caregivers or family members.The RNCM initiates preventative and rehabilitative procedures or programs as appropriate for the participants’ care and safety.The RNCM administers medications and treatments, as ordered by the physician/NP, and monitors the participant’s response. The RN notifies the appropriate medical personnel of changes in the participant’s status.The RNCM demonstrates knowledge of the medications he/she administers and instructs the participant/family in safe administration of medication in the home. Assesses for and encourages compliance with medication regimen.The RNCM recognizes and understands the significance of abnormal test results and utilizes critical thinking skills when gathering participant data, planning for, and implementing care.The RNCM provides safe total patient care to participants with complex health problems with a focus on the individual participant and the family.The RNCM maintains all standards of nursing practice and follows hospital policies/procedures for care delivery and medication administration.The RNCM leads and monitors licensed and other professional and non-professional staff in the delivery of nursing care to the participant in the home. The RN is responsible for monthly supervision and subsequent documentation of home health aide services provided in the participant’s home.The RNCM evaluates participant outcomes and or progress toward achieving the objectives/goals of the care plan and communicates this information among other members of the Multidisciplinary Team.The RNCM collaborates with the Interdisciplinary Team to revise the plan of care based on changes in the participants’ physical or psychosocial status, and initiates actions that are consistent with the changes in status.The RNCM participates with patients, families and members of the Interdisciplinary Team to evaluate/measure the individual and group response to nursing care and teaching interventions and documents the outcomes of the problems identified at every scheduled review.The RNCM maintains accurate and timely records of participant’s functional /health status, progress toward care plan outcomes, revisions to care plans, care given, etc. All charting and documentation is performed in accordance with CSI policies/procedures. The RNCM participates in the collection and documentation of Data PACE information.The RNCM advocates to others on behalf of the participant, and demonstrates accountability in resolving participant concerns or issues.The RNCM understands, complies with and promotes the Participant Bill of Rights and assesses and works toward achieving high levels of participant satisfaction.The RNCM may provide after hours on-call medical assistance on a rotating basis, via phone triage or after hours home visits to participants as needed.Schedule requires a rotating on call shift.KNOWLEDGE, SKILLS AND ABILITIES:
Must be a Registered Nurse with current Michigan licensure, BSN preferred.The RNCM participates in annual, mandatory in-service training and screening, including but not limited to: infection control, TB testing, safety training, and BLS training.The RNCM assumes responsibility for self-development through continuing education, utilizing resources within the health care system or elsewhere; the RN promotes professional behavior and growth by serving as a role model within the health team.The RNCM must possess a current State of Michigan driver’s license and maintain an acceptable driving record.The RNCM has the ability to establish and maintain interpersonal and interdepartmental relationships.The RNCM has the ability to apply principles of adult learning in planning and implementing educational activities.The RNCM has the ability to lead and direct other licensed and non-professional nursing staff in the delivery of care.The RNCM participates in and/or facilitates Quality Assurance projects resulting from data results.The RNCM assists with the implementation of nursing research studies.The RNCM reviews current periodical literature relevant to the general practice of nursing as well as information pertaining to the PACE model of care.The RNCM ensures adherence to departmental and external standards in the provision of quality focused care by attendance at professional meetings/committees and review of national standards of practice.Must meet a standardized set of competencies (approved by CMS) after working independently.Must have one (1) year of experience with a frail or elderly population.WORKING CONDITIONS:
Works in the participant’s home which is an uncontrolled environment. May be exposed to potentially infectious materials, blood-borne disease pathogens, and hazardous waste. Must be medically cleared for communicable diseases and have all immunizations up-to-date after engaging in direct participant contactDriving is required within PACE SEMI catchment area, with possible exposure to extreme temperatures, including heat and cold. Must have reliable transportation available on a daily basis.Frequent walking, bending, lifting of forty (40) pounds or more may be needed in the performance of duties. Read Less