Responsibilities

Works-From-Home with 25% travel to the centers - working with staff; 

Under the direction and supervision of the Chief Nursing Officer, the Manager of RN (Registered Nurse) Case Management leads and manages a national team of RN Case Managers across 6 states, ensuring the provision of comprehensive and coordinated care to our participants. They perform daily coordination of acute care with inpatient hospital staffing and actively assists physicians and hospital staff in the management of InnovAge admitted participants by facilitating care through interaction with hospital departments and community services. Review for medical necessity and level of care appropriateness while coordinating post-hospital discharge planning. The RN Case Manager collaborates with the interdisciplinary team daily to coordinate appropriate plan of care for post hospital visit for InnovAge PACE, but also shift engagement include preventative care - focusing on our most at risk participants to mitigate utilization. This is a new position to the organization focused on improving participant engagement, satisfaction and mitigating reoccurrence/readmittance. 

Leadership– 75%

• Provide strategic direction and guidance to the RNCM team, ensuring alignment with organization goals and mission.
• Supervise and support RNCM, providing mentorship, training, and professional development opportunities to enhance their skills and knowledge.
• Foster a collaborative and inclusive work environment that encourages teamwork, communication, and a patient-centered approach to care.
• Collaborate with the IDT to coordinate care plans and optimize the delivery of care.
• Ensure compliance with all applicable regulatory requirements, accreditation standards, and best practices in case management and nursing.
• Establish and monitor key performance indicators to assess the quality, efficiency, and outcomes of RN Case management services.
• Conduct regular audits and quality improvement activities to identify areas for improvement and implement corrective action as needed.
• Collaborate with community organizations and healthcare providers to enhance participant access to community-based services.

Participant Nursing– 15%

• Assesses, develops, plans, and evaluates care provided to participants while admitted in hospital settings.
• Collaborates with physicians, other members of the interdisciplinary health care team, and patient/family in the development, implementation, and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resources upon discharge.
• Participates within the interdisciplinary team in the formulation of Plans of Care for InnovAge PACE program participants, as well as in other interdisciplinary team settings that plan, coordinate and monitor the care of InnovAge PACE program participants
• Recommends alternative levels of care and ensures compliance with federal, state, and local requirements.
• Assesses high-risk patients in need of post-hospital care planning.
• Collaborate with hospital staff to develop and coordinate the implementation of a discharge plan to meet participants identified needs.
• Communicates the plan to physicians, patient, family/caregivers, staff, and appropriate community agencies.
• Reviews, monitors, evaluates, and coordinates the patient's hospital stay to assure all appropriate and essential services are implemented timely and efficiently.
• Collaborate with the medical clinic to triage participants for priority of care and routes accordingly. Oversees appointment scheduling and ensures priorities are made based on participants in needs.
• If required, visit participant in the hospital setting to help coordinate care and discharge plan.
• Provides participants with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness.
• Responds to and performs coordination of care for admitted participants.
• Oversees scheduling of appointments for post discharge care for primary care visits.
• Assists in the examination, testing and treatment of participants.
• Processes orders and disseminates orders and instructions to appropriate personnel, in addition to implementing orders written by primary care physician(s).
• Instructs participants and family regarding medications and treatment instructions.
• Oversees scheduling of specialist appointments and assists in hospital admissions and calling report to unit.
• Performs general nursing care to participants including administering prescribed medications and treatments.
• Observes, records, and reports participant’s condition and response to medications and treatments to physicians.
• Documents all necessary information and maintains participant medical record(s) and fulfills agency charting and reporting requirements.

Administration– 10%

• Provides after hours on-call support to primary care providers for hospital related discharges.
• Develops, implements, and maintains a current nursing care plan in cooperation with the center nursing team.
• Coordinates transfer of patients to appropriate facilities; maintains, and provides required documentation.
• Maintains and reviews participant records, charts, and other pertinent information.
• Request documents of in hospital stay and examination results for participant records.
• Effectively communicates in interdisciplinary team meetings, family meetings, and clinic meetings.

REQUIRED

• Current COMPACT Registered Nurses License covering CO, NM, PA, VA, FL is required. CA License is required at time of hire but no later than 6 months from start date. 
• 5 yrs RN Case Management - coordinating care and discharge planning in acute setting
• 3 yrs RN working in healthcare with an emphasis in acute setting geriatrics
• 3 yrs leadership experience
• 1 yr working with the frail or elderly 
• Current CPR certification or the ability to obtain CPR certification

PREFERRED

• Certification as a Gerontological Nurse
• Bi-lingual-Spanish, Russian, Punjabi or Hmong

Benefits

InnovAge’s Program of All-inclusive Care for the Elderly (PACE) is an alternative to nursing facilities. Seniors receive customized healthcare and social support at a nearby PACE center supported by a team of medical experts dedicated to providing personalized healthcare and support to help them age at home. Our greatest assets are our team members who make a difference in the lives of those we serve every day. ​Elevate your future with co-workers passionate about a patient-centered care model supported by comprehensive services to improve the quality of care while reducing over-utilization of high-cost care settings.

As an equal opportunity/affirmative action employer InnovAge is committed to and values an inclusive and diverse workplace. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender, gender identity/expression, national origin, disability or protected veteran status, pregnancy or any other status prohibited by applicable law. 

Salary ranges are dependent on a variety of factors, including qualifications, experience, and geographic location. Range is not inclusive of potential bonus or benefits. Comprehensive benefits include m/d/v, short and long-term disability, life insurance and add, supplemental life insurance, flexible spending accounts, 401(k) savings, paid time off, and company paid holidays.

Posted Salary Range