Short Stay Transitions Manager
The Nursing Team at Suites at Someren Glen is seeking a Short Stay Clinical Manager- Registered Nurse to join our community. Join an exceptional nursing team in our newly renovated Rehab department. The Management Team at Suites at Someren Glen fully believe that empowered employees are the key to great quality care.
The schedule for this position is Monday - Friday from 8:00 am - 5:00 pm.
Salary Range: Minimum: $29.50/hour - Maximum: $36.13/hour Based on Experience.
Below is the Job Description for this position:
Position assumes the responsibility and accountability for collaborating, directing, following and coordinating the care and services provided by the skilled nursing Transitional Care Neighborhood to align with the short stay guest’s goals as well as those of the acute and post-acute continuum of care providers. This position is responsible for effectively facilitating a successful transition from the acute care setting, hospital, LTAC, acute rehab, into the Transitional Care Neighborhood. Facilitates and provides oversight of the care of the guests as well as provides information to guest families and /or MDPOA. Assists the guest in becoming proficient and comfortable with managing their own care, providing guidance to the guest and family for effective care transitions, improved self management skills and enhanced provider-to-guest communication. The care transitions manager helps facilitate interdisciplinary communication and collaboration across multiple settings. Responsible for managing 20+/- team members to include coaching and training, corrective action planning, goal setting, and conducting Gifts and Growth and Touch Points. Responsible for managing rehabilitation services including vendor management and relationships, team member rehab competencies and training.
- Coordinates the work of team members to meet guest goals and expectations.
- Performs post-admission screening to determine the guest’s level of current knowledge of the disease processes.
- Develops a coaching relationship with the guest and relevant care partners and empowers the guest to actively participate in the plan of care. Assists the guest in developing personal goals that are pertinent and measureable.
- Follows up with required communication, support and education with guest/family and team members to reduce the risk of readmission post discharge.
- Coordinates and evaluates care conferences, care plan updates and IDT meetings including discharge plan, rehab and transition goals. Oversees discharge planning and case management.
- Implements all guest education materials and disease management teaching (COMS).
- Ensures effective communication both internally and externally to foster continuity of care and ongoing relationship building with case managers.
- Evaluates guest readmissions and makes recommendations for QAPI.
- Implements INTERACT tools with staff to promote improved care practices, better communication and reports.
- Evaluates guest readmissions and makes recommendations for quality improving best practices.
- Identifies guests in need of advanced care planning and initiates palliative/hospice care.
- Participates in the review of quality indicator reports and implements corrective action as necessary to include QAPI for hospital readmissions.
- Responsible for encouraging, participating and integrating Masterpiece Living and Eden Alternative initiatives by supporting successful aging and person-centered programs and culture.
- Evaluates the need for, organizes and coordinates educational programs in line with federal, state and local regulations and company policies.
- Monitor delivery of care by other nursing staff. Implement corrective action as necessary.
- Ongoing preparation for annual state survey.
- Maintaining established position of service excellence to include CMS rating system, quality measures and word of mouth reputation.
- Other duties as assigned.
Basic Qualifications & Experience:
- Colorado RN required in good standing required. BSN preferred.
- Minimum of 3 years of related RN experience.
- 1-3 years in a supervisory capacity required
- Must be knowledgeable of state and federal laws and regulations for skilled nursing facility operation in the State of Colorado.
- Proven leadership abilities and comprehensive knowledge of healthcare transitions including Medicare and Medicare Advantage plans, as well as expertise in PPS, MDS, OBRA and OSHA preferred.
- Must understand long term care/hospitals and the importance of technology to improve resident care.
- Administrative experience preferred.
- Must have computer word processing and database experience.
- Must possess excellent customer service skills
- Must be able to read, write and speak the English language.
Working Conditions / Physical Requirements
- Sits, stands, bends and moves intermittently during working hours.
- Is subject to frequent interruptions.
- Interacts with donors, families, volunteers, residents and numerous other staff members.