• Home Care Coordinator Nurse

    Posted: 08/02/2020

    Home Care Coordinator Nurse
    NOW OFFERING SIGN ON BONUSES up to $3,000 for RNs and LPNs!
    The Registered Nurse/Licensed Practical Nurse has the responsibility for providing direct and indirect nursing care to participants in the PACE Center and in the community. Works under the direct supervision of the Medical Director or designee but is independent in the application of advanced nursing knowledge and skills in all settings. Manages complex clinical situations for which he/she is responsible. May be utilized in the PACE Clinic or in the community in participant homes.
    Key Responsibilities
    • Ability to assess the home care needs during initial, periodic, routine, and acute assessments conducted every six (6) months minimally. 
    • Participates in the development of a care plan with the IDT (Interdisciplinary Team), participants, and family/caregiver
    • Provides participant/caregiver education and support for 24/7 coordination of care, to ensure that quality services are provided to meet participant needs
    • Ensure all needed medical supplies are provided in the home setting under the guidance of PACE providers
    • Coordinates and authorizes all Durable Medical Equipment (DME) in the home with IDT, and with the guidance of Physical and Occupational Therapists
    • Ensure all durable medical equipment is in place and in good working order
    • Monitors participant, family and caregiver’s ongoing functional/psychological status and appropriateness of care, according to the plan of care
    • Coordinates all nursing care for participants in the clinic and at the participant’s place of residence (i.e., home, AFC, or SNF)
    • Demonstrates active participation in QIP process
    • Coordinates hospital discharges with contracted provider team and the IDT
    • Daily communication of any changes in participant condition (in any care setting) with contracted provider team, IDT, and PCP  
    • Provides routine home and facility visits as directed to provide needed services or follow-up
    • Participates in hospital rounding meetings if necessary
    • Participates as an active member of the Interdisciplinary Team
    • Participates in daily IDT meetings or CarePod huddle as directed
    • Identifies and refers potential quality concerns to Utilization Review Committee
    • Assists in pharmaceutical management delivery systems, performs wound care and lab specimen collection at the participant’s place of residence (i.e., home, AFC, or SNF)
    • Assists participants with modality and physical therapies/exercises
    • Monitor participant vital signs, temperature, respiration, etc.
    • Conducts wellness visits
    • Abides by all established PACE of Southwest Michigan policies, rules, and regulations
    • All other duties as assigned, which may include on-call rotation
    Graduate of an accredited school of nursing with RN or LPN degree required
    2 years RN or LPN experience
    Experience in either home or community health preferred
    For more information and to apply for this position, please click the following link: Home Care Coordinator Nurse

    Allyson Baldwin
    Human Resources Generalist

    p: (269) 408-4325
    e: allysonbaldwin@paceswmi.org
    w: www.paceswmi.org