The RN Case Manager for Medical Respite will be part of a collaborative, multidisciplinary team that will support the clients in the medical respite program. The Medical Respite Program allows individuals who are experiencing homelessness a safe place to rest and recuperative from a medical condition. While participants focus on improving their health, they can also work on addressing other needs like housing and benefits. The RN Case Manager will assist in assessing patients for placement to the program, visit and monitor program participants regularly, and provide general nursing care as needed as defined by the Texas Board of Nursing. The RN Case Manager is an integral member of the Medical Respite team and supports with oversight to the program. The RN Case Manager position will involve exciting and innovative opportunities to help grow the program. We invite you to join a compassionate team that is committed to serving individuals with the greatest needs. The RN practices professional nursing as defined by the Texas Board of Nursing, Texas Nurse Practice Act and by adhering to organizational policies, procedures, and guidelines. Our nurses are committed to providing a collaborative
environment to provide the safest and highest quality of care for our patients.

This position is considered an onsite role. Individuals in this position may work both at an approved off-site location and onsite at a primary location or multiple locations based on business needs.

To be considered for this role, candidates must live in the greater Austin/Travis County area.

Essential Functions:

• Coordinate with local hospitals, community clinics and other programs to review referrals according to inclusion criteria. This may include traveling to do in person assessment.
• Completing accurate assessment of discharge needs, coordinating medication and appointments, reporting to appropriate personnel as indicated and working collaboratively with primary care providers, specialists, and community providers such as hospitals.
• Perform nursing case management which includes completion of assessment upon admission, reconcilingmedications and review medications against list from primary care  provider and/or hospitals. Provide individualized care coordination of local resources, scheduling medical appointments and assisting patient-clients in obtaining needed medications or other resources to improve their health and well-being. Proactively manage and follow-up with patients according to the specified care plan.
• Supports patients by accommodating for disabilities/learning barriers (vision impairment, dyslexia, illiteracy), providing client education that is tailored to the individual learning style, facilitating comfort in the shelter setting, establishing a patient-centered med routine (pill boxes, education), and employing therapeutic listening.
• Provide direct nursing care (vital signs, disease/medication education, basic wound care) to patients in medical respite facility and ensure all needs of the patient are met, in conformance with established policies and procedures.
• Attends and participates in weekly team care huddles/conferences.
• Maintain a positive relationship with Medical Respite partners such as Urban Alchemy, New Entry, etc. by communicating opportunities to improve the patient experience.
• Enhance the client experience by addressing and resolving client and program issues in a timely manner utilizing supportive conflict resolution practices.
• As indicated, escalates emergencies to the hospital and non-emergent health concerns to PCP.
• Complete daily/weekly quality assurance checklists to include delegation of tasks as appropriate to staff (McKesson, CLIA, equipment checks, supply management, etc.) and assist with oversight of infection control standards.
• Act as a resource for other clinical team members.
• Assists with interviewing, selecting, and training employees.
• Assists with planning, directing and delegating tasks to Medical Assistants.
• Adheres to the Texas Board of Nursing and Texas Nurse Practice Act requirements and to other governing agency regulations.
• Support organizational initiatives to promote and maintain a strong positive workplace culture.
• Attend staff meetings and education offerings both in person and via teleconference/online as required.
• Ensure all tasks provided and associated with client care, patient administrative processes and related duties comply with all regulatory and accreditation standards, and Central Health Standard Operating Procedures, Policies and Procedures.
• Participate in continuous quality improvement projects in order to better serve the patient-client, family and healthcare system to improve the quality of service provided.
• Perform other duties as assigned.

Knowledge, Skills and Abilities:

• Sound-critical thinking and decision-making skills.
• Consistently superb customer services skills; excellent interpersonal/assertive communications skills demonstrating a high degree of emotional intelligence.
• Knowledge of homeless issues and demonstrated sensitivity to underserved populations.
• Skill in oral and written communication with healthcare providers in a variety of settings.
• Ability to communicate effectively with patients of various ages, educational and cultural backgrounds.
• Ability to communicate effectively with diverse community audiences.
• Skill in fostering and maintaining positive relationship with a number of community partners.
• Skill in prioritizing and organizing multiple responsibilities simultaneously.
• Skill in triaging and ensuring appropriate level of care for a patient in an accurate and efficient manner.
• Skill in documenting in a thorough and clear manner.
• Skill in operating office equipment, such as computers, software (i.e., Microsoft outlook, excel), faxes and telephones.
• Ability to function as a member of a multidisciplinary team.

Required Education: 

Graduation from an accredited school of Nursing

Required Experience:

Two (2) years of nursing experience in a clinic, hospital or related setting

Required Licensure:

Unrestricted Registered Nurse License in the State of Texas

Basic Life Support (BLS) ‐ Obtained through approved American Heart Association or Red Cross.