Journey Hospice, a program of Lutheran Social Ministries of New Jersey, offering support to our clients, their family and loved ones during that journey, has a unique opportunity for a Full-Time RN Case Manager!
Through the power of the Holy Spirit and in response to God’s love as revealed in the Gospel, the mission of Lutheran Social Ministries of New Jersey is to serve those in New Jersey who hurt, who are in need, or who have limited choices.
LSMNJ team members are dedicated to providing healing, hope and hospitality, regardless of religious background through a diversified social ministry program addressing many critical human care needs.
We are seeking employees that share those same values and want to make a difference in the lives of those we serve.
This position is full-time offering competitive compensation, a robust benefit package and generous paid time off.
Oversees primary caseload of Hospice patients and provides skilled professional nursing care to them, their families and caregivers as prescribed by the physician and in compliance with the Hospice Medicare Conditions of Participation, New Jersey Hospice licensure laws, accrediting body standards and agency policies and procedures. Provides the initial assessment and comprehensive nursing assessment and identification of problems of each patient; reassessment of nursing needs and collaborates to develop the Hospice Interdisciplinary Team (IDT) plan of care. Implements the plan of care and reevaluates and revises the plan of care relative to the patient’s nursing needs to provide appropriate, comprehensive and responsive goals and interventions. Teaches, supervises, and counsels the patient, family members, and staff regarding nursing care and the patient's needs, including other related problems of the patient at home. Works closely with other members of the IDT to ensure all patient and family care needs are being met. Provides supervision to Hospice Aides/Homemakers
- Supports the mission and values of Lutheran Social Ministries of New Jersey, which is: Through the power of the Holy Spirit, and in response to God’s love as revealed in the Gospel, the mission of the Lutheran Social Ministries of New Jersey is to serve those in New Jersey who hurt, are in need, or have limited choices.
Follows all Lutheran Social Ministries of New Jersey Policies and Procedures and OSHA safety guidelines.
- Seek and obtain sufficient information necessary to function effectively in the Hospice setting where the patient/family/caregiver is receiving care.
- Conduct initial assessment, including physical, emotional and psychosocial aspects, of patient/family/caregiver in a thorough, accurate, compassionate and timely fashion.
- Utilize the nursing body of knowledge to provide leadership and guidance to the IDT in formulating and individualizing the interdisciplinary plan of care to include problem identification, interventions and goals to address palliative comfort measures for the terminally ill patient, family and caregiver.
- Contribute to identifying both active and potential needs of the patient and his/her family, which may affect the plan of care.
- Consistently collaborate with the physician to plan and implement the medical and nursing plan of care.
- Review the nursing component of the comprehensive interdisciplinary plan of care with the IDT. Communicate in writing in the clinical record and verbally with the IDT to coordinate interventions and ensure continuity of care.
- Facilitate and participate in the IDT care conference and contribute to patient care planning.
- Provide nursing interventions and appropriate preventative and therapeutic nursing procedures.
- Nursing staff shall administer medications in accordance with all Federal and State laws and rules.
- Collaborates with IDT members to provide continuous assessment of assigned patients, interprets findings, initiates appropriate therapeutic actions and evaluates the results of these actions.
- Accepts responsibility of assignment to perform a specialized procedure only when qualified with specialty training, proven competency, clinical background and expertise in the specialty area.
- Works in cooperation with family/caregiver and IDT members to meet the physical and emotional needs of the patient/family/caregiver.
- Provides appropriate information and explanation to the patient and patient’s family.
- Facilitates patient and family education to promote continuity of care and optimal patient/family outcomes for quality of life as defined by the patient/family/caregiver.
- Demonstrates expertise in the utilization of all IDT members including volunteers and community resources.
- Fulfills productivity requirements on an average daily census basis as determined by acuity level and Administrator.
- Documents accurate, complete and relevant clinical notes regarding patient’s condition and care given. Maintains documentation on a timely basis.
- Assesses the dietary/nutritional needs of Hospice patient and provides appropriate interventions relative to nutritional intake as the patient’s condition progresses.
- Acts as a mentor to other personnel by participating in orientation and assisting with field training and in-service education to contractors and referral sources, as needed.
- Participates in formal and informal in-services, and patient care conferences to promote professional growth of all interdisciplinary team members.
- Teaches the patient, family and/or caregiver regarding the progression of the disease process and self-care techniques as appropriate, which includes providing medication, dietary/nutritional counseling support and other instructions as ordered by physician, recognizing and utilizing opportunities for health counseling.
- Per Medicare Conditions of Participations, performs an on-site supervisory visit at least every fourteen (14) days (or more frequently as needed) to assess the quality of care provided by the Hospice Aide/Homemaker and to ensure that services ordered by the Hospice IDT meets the patient’s/family’s needs. Documents supervisory visit in the patient record.
- Completes an annual on-site visit to the location where a patient is receiving care to observe and assess each Hospice Aide while performing care. Assesses the Aide’s ability to demonstrate initial and continued satisfactory performance in meeting outcome criteria that include, but are not limited to:
- Following patient’s plan of care and completing tasks assigned by the RN
- Creating successful interpersonal relationships with the patient and family
- Demonstrating competency with assigned tasks
- Complying with infection control policies and procedures
- Reporting changes in the patient’s condition.
- Evaluates effectiveness of educational experiences and teaching methods in order to promote ongoing professional development of Hospice staff and quality patient outcomes for patients, families and caregivers.
- Manages daily visits and assignments for maximum efficiency.
- Visit frequencies are according to individual patient needs and acuity.
- Visit frequencies are reviewed at least weekly and altered to meet patient needs and acuity.
- Patient care visits are coordinated with all IDT members in order to utilize manpower resources and provide optimal patient care.
- Ensures adequate and appropriate inventory of supplies and equipment for the provision of patient services and promotes the efficient use of equipment and supplies.
- Maintains confidentiality in patient related matters.
- Demonstrates behavior appropriate as a role model and leader including adhering to the agency code of conduct.
- Demonstrates creativity and critical thinking ability when participating in IDT conferences, developing patient care plans or completing assigned projects.
- Assumes leadership role to facilitate interdisciplinary care coordination and collaboration.
- Functions without supervision, utilizing time constructively and organizing assignments for maximum productivity.
- Introduces self and clarifies role to patient/family/caregiver, physicians, nursing facility staff and other referral sources.
- Recognizes and responds appropriately to verbal and non-verbal cues.
- Communicates effectively with all members of the IDT by:
i. Defending and supporting peer/team decisions and actions.
ii. Asserting self with tact.
iii. Supporting collaboration and team decisions/plans.
iv. Maintaining open communication.
v. Offering suggestions and criticisms constructively.
vi. Asking questions and sharing information during IDT conferences and nursing facility care conferences.
- Relates complete and pertinent information in verbal and written communication. Maintains clinical records, statistics, and reports as prescribed and in compliance with local, state and federal laws.
- Initiates and maintains open and effective communication with supervisor as well as members of the IDT as evidenced by improved patient outcomes.
- Coordinates travel time for visits and manages a caseload to deliver care in a cost-effective manner that demonstrates an understanding of Hospice reimbursement methodologies.
- Assures proper maintenance of records per agency guidelines.
- Participates in evening/weekend on-call as required, conducting on-call services in a clinically competent and responsive manner.
- Participates in the QAPI process by finding opportunities for continuous monitoring and identification of patient outcomes, intra/interdepartmental and environmental concerns.
- Displays a willingness to utilize problem solving techniques to insure appropriate interventions and resolutions.
- Participates in clinical record review.
- Completes a minimum of twelve (12) hours of in-services per year.
- Treats employees, patients, and business partners with respect. Fosters teamwork by trusting and supporting each other while encouraging collaboration at all levels of the organization. Embraces diversity and demonstrates the ability to work together.
- Maintains confidentiality of all agency and patient related information. Protects patient rights as defined in the patient Bill of Rights.
- Maintains proper attendance and punctuality to ensure that the department is operated in an efficient and cost effective manner.
- Adheres to departmental and agency dress code outlined in the organization’s policy.
- Completes annual compliance and HIPAA training and exhibits behavior as set forth by the LSMNJ Code of Ethics and Business Integrity in the performance of duties.
- Adheres to the Organization’s Policies and Procedures regarding the Compliance Program of the organization and is timely in reporting any possible concerns.
- Follows all local, state and federal regulations as they pertain to the position.
- Adheres to the Organization’s Policies and Procedures covering Privacy and Security in Compliance with HIPAA regulations.
- Maintains the confidentiality of all company procedures, results, and information about participants, clients or families.
- Practices Universal precautions and follows appropriate Infection Control procedures.
- Maintains a safe working environment. Follows LSMNJ Safety Policies and Procedures.
- Participates in continuing education classes as assigned and any required staff and training meetings.
- Maintains professional affiliations and any required certifications.
- Other duties as assigned by my supervisor necessary for the efficient operation of the department/facility.
Graduate of an accredited registered nursing program.
Bachelor’s degree in Nursing preferred.
Certified Hospice and Palliative Nurse (CHPN) certification preferred.
NJ RN Licensure by the NJ State Board of Nursing in good standing.
Valid drivers license and reliable transportation that is nsured in accordance with NJ state requirements.
Skill(s): Skills and Knowledge:
- Must maintain a professional attitude and demeanor and is able to communicate effectively and relate courteously and cooperatively with patients, caregivers, colleagues, supervisors, co-workers and all others.
- Must be able to demonstrate optimism, enthusiasm and willingness to work constructively with other health care team members and reflect concern for the well being of patients and employees.
- Interacts with all staff in a positive fashion supporting the mission and vision of LSMNJ.
- Minimum of one (1) year general nursing preferred with current hospice, home health, medical, surgical or critical care experience.
- Experience with pain and symptom management interventions preferred.
- Ability to work within an interdisciplinary setting.
LSMNJ is an Equal Opportunity Employer.