RN Case Manager - Hospice

Primary functions are to administer skilled nursing care for clients of all ages in their place of residence, coordinate care with the interdisciplinary team, patients and their families, and a referring agency. Assumes the responsibility for coordination of care.

Job Qualifications:

Education: Graduate of an accredited Diploma, Associate or Baccalaureate School of Nursing

Licensure: Current State license as a Registered Nurse, current Driver's License.

Experience: One year of experience as a Registered Nurse in a clinical care setting required. Home health experience preferred.

Knowledge and Skills:

• Nursing skills as defined as generally accepted standards of practice
• Good interpersonal skills
• Proof of current CPR

Transportation: Reliable transportation and valid and current driver's license and auto insurance

Environmental and Working Conditions:

Works in patients' homes in various conditions; possible exposure to blood and bodily fluids and infectious diseases; must have the ability to work a flexible schedule and the ability to travel locally; some exposure to unpleasant weather; PRN emergency call.

Physical and Mental Effort: Prolonged standing and walking required, with ability to lift up to 50 lbs and move patients. Requires working under some stressful conditions to meet deadlines and patient needs, and to make quick decisions and resource acquisition; meet patient/family individualized psycho social needs. Requires hand-eye coordination and manual dexterity.

Essential Functions:

• Completes initial and ongoing assessments to identify the physical, psychosocial, and environmental needs of home health patients/clients . Completes assessments at appropriate time points, including Outcome and Assessment Information Set (OASIS) or other assessments as appropriate to the patient.
• Regularly re-evaluates the patient's/client's nursing needs and evaluates the outcomes of care.
• Develops, initiates, and revises the plan of care as necessary to ensure quality and continuity of care. Initiates appropriate preventive and rehabilitative nursing procedures. Refers to other services as needed. Plans for the discharge of the patient/client from services.
• Furnishes those services requiring substantial and specialized nursing skill. Counsels the patient/client and their family in meeting nursing and related needs. Uses infection control measures that protect both the staff and the patient (OSHA).
• Coordinates services. Informs the physician and other personnel of changes in the patient's/client's condition and needs.
• Monitors assigned cases to ensure compliance with requirements of third party payors.
• Prepares clinical and progress notes. Completes appropriate documentation in a timely manner.
• Demonstrates commitment and professional growth by participating in in-service programs and maintaining or improving competency.
• Supervises, teaches and provides clinical direction to other nursing personnel. Assigns home health aides to specific patients. Supervises LPNs/LVNs and paraprofessionals providing services to patients/clients. May only conduct aide competency evaluations if qualified with two years of clinical experience and one year of home health experience.
• Promotes the Agency 's philosophy and administrative policies.
• Performs on-call responsibilities and provides on-call services to patients/clients and their families as assigned.

Provides effective communication to patients/clients, their family members, team members, and other health care professionals.

Traditions Health is becoming The Care Team, aligning with a leading provider of hospice care, committed to providing the best possible care to their patients and families, and employees. Candidates selected for this position will transition to employment with The Care Team effective January 1, 2026. You will have the opportunity to contribute to meaningful work, supported by The Care Team values, resources, and commitment to caring for the communities we serve.

You will be offered The Care Team benefits plan with PTO starting January 1, 2026.

About The Care Team

At The Care Team, our purpose has always been clear: to deliver exceptional hospice care that brings comfort, dignity, and peace to patients and their families wherever they call home. Since our founding in 2015, we have grown to be a leading provider of hospice services in Michigan, with locations throughout the state and additional presence in Indiana and Pennsylvania. Our exceptional Care Team members are the heart of what we do and include incredible nurses, medical social workers, aides, chaplains, and dedicated volunteers who work together to support both patients and their families. We believe that every person deserves to be cared for with compassion, respect, and excellence during life's most tender moments. That belief is what unites us and makes our work so meaningful. For more information, visit tctcares.com