RN Clinical Support Specialist
WestCare Health System - Sylva, NC

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Responsible for the coordination of referrals to the hospice & palliative care programs from hospitals, physicians, community agencies, etc. to maximize patient care and insurance reimbursement. Coordinates the agency’s Quality and Performance Improvement monitoring to support quality in patient care delivery systems and processes.

Essential Job Functions:
o Coordinates the referrals and admissions process with the hospice team, billing staff, and other leadership team members to ensure optimal patient transitions & outcomes.

o Gathers patient demographic data, medical history, diagnosis codes, and physician referral orders and appropriately enters the information to establish an electronic medical record for each patient.

o Communicates information to the referred client/family in regards to billing responsibilities, admission criteria, and hospice guidelines/expectations.
    • Prepares and sends to physician a CTI for all new admissions. Ensures CTI is returned prior to admission of patient.
o Coordinates scheduling of admissions with the clinical discipline supervisors.

o May utilize office clerical support to assist with data entry needs for the intake process as coordinated with the Agency Director.


o Coordinates the agency’s Quality and Performance Improvement monitoring and auditing

o Collaborates with hospice leadership to identify performance improvement opportunities, design and facilitate implementation of PI projects, and monitor outcomes to ensure quality patient care delivery

o Maintains databases to aggregate and trend PI data and performs regular audits on documentation in patient records and provides results of audits to Hospice Leadership. Audits include but are not limited to:

i. Admission Chart Audits within five days post-admission – 100% of Patients

ii. Closed Chart Audits within ten days post-discharge – 100% of Patients

iii. Recertification Chart Audits within ten days post-recertification – 100% of Patients

iv. Post General Inpatient Chart Audits within five days of hospital discharge – 100% of Patients

v. Clinical Care Audits – 30 Patients per month

vi. Routine Visit Audits – 10 Nursing Visits, 5 Aide visits, 5 Social Work Visits per month

vii. Other audits as needed or requested

o Accompanies staff members on visits for observation purposes and teaching experiences.
o Supports field nurses by assisting with nursing responsibility and visits for their patients when necessary or as requested by the Patient Care Supervisor

o Available to respond to clinical needs or calls placed to Hospice and Palliative Care as necessary.

o Provides appropriate counsel to patient/family within the scope of the nursing practice and uses other members of the interdisciplinary team to meet patient/family needs outside the scope of nursing practice.

o Provides support appropriate to the level of knowledge, skill, comfort, and acuity of each patient/family.

o Maintains up-to-date patient clinical records so that problems, plans, actions, and goals are accurately and clearly stated and changes are reflected as they occur.

o Shares in providing 24-hour, seven-day-a-week nursing call coverage for all patients on census.


o Maintains an efficient, professional relationship with physicians, physicians’ staff, hospital staff, and other hospice employees.

o Demonstrates familiarity with and upholds policies of the agency and the rules and regulations of regulatory agencies governing the delivery of hospice services.

o Participates in educational opportunities supported by the agency and self-development activities to promote professional development.

o Assists in the orientation of new staff & volunteers.

Other Job Functions

· Accepts other assignments as appropriate and completes special projects as required.

· Uses independent judgment and decision-making to organize work and establish priorities.

· Responsible for department patient satisfaction scores, productivity, and employee engagement, along with other members of the hospice and palliative care team.

· Responsible for information discussed in staff meetings and inservice training.

· Maintains a reliable vehicle for transportation to accomplish work.

· Maintains a valid driver’s license with motor vehicle record acceptable to MedWest's auto liability insurance carrier.

· Work responsibilities may involve access to medication storage areas to perform core job functions, deliver non narcotic medications or restock supplies.


The following qualifications are the minimum requirements necessary to adequately perform this job. However, an equivalent combination of experience, education and training which provides the necessary knowledge skills and abilities would be acceptable, subject to any legal and/or regulatory requirements.

· Registered Nurse with current licensure to practice nursing in North Carolina is required.

· BSN is desired

· CHPN certification is desired

Preferred Experience :

· At least two years of hospice nursing experience.

· Able to relate well to death/dying situations and support the Hospice concepts.

· Computer skills: All Microsoft applications (Word, Excel, Publisher, Power Point, Outlook) and use of electronic medical records.

· Other Skills:

o Must have excellent organizational skills and ability for multi-tasking.

o Must be able to complete required paperwork with accuracy and meet prescribed deadlines.

o Must be innovative in problem solving and communicate well.

o Must be able to work without continuous supervision.

o Must be able to react to crisis situations independently.

· Work is not completely standardized. Assignments are often received in the form of results expected, with due dates and general procedures to follow.


The nurse may be required to assist in moving and lifting patients, to push/pull heavy objects (i.e.; wheelchairs or stretchers) to stay on his /her feet for long periods, bend and stoop and reach above shoulder height. Patients may vary in size from as little as 4 lbs. to as large as 400 lbs., and may be totally dependent in all aspects of daily living or relatively independent. There is a moderate amount of potential exposure to infectious materials. Mentally, he/she may be required to reassure distressed and frightened patients; motivate resistant/apathetic patients; support grieving patients and families; respond to patient emergencies with calm efficiency. Discuss death and dying issues with patients and families, including advanced directives/DNR orders. Deal with the emotional burden of working with individuals who are disabled, sick or dying. All above must be accomplished without impairing the caregiver’s job performance. Eye and hand coordination, manual dexterity for computer and writing skills and visual acuity required. Ability to communicate using written and verbal media.


The Registered Nurse works primarily in the office environment and patient’s home environment. Normal working hours are 8:00am to 4:30pm Monday through Friday with on-call coverage evenings and weekends and holidays on a pre determined rotational basis. The nurse must have reliable transportation to make patient visits; valid driver's license and automobile insurance. Must maintain an acceptable motor vehicle record in order to be covered by the system’s automobile liability insurance carrier. Must be able to physically access any home in the service area. (I.e. navigate stairs, narrow spaces, tolerate lack of heat or air conditioning). Must have endurance to be able to manage demands of home care field work i.e. travel, time, home arrangements and stress both physical and emotional. Must be able to use equipment with visual and auditory mechanism: lift patients as per patient contact, infant to adult; maneuver patient care equipment and be able to communicate in English.


· Dotted line reporting responsibility to the Supervisor of Patient Care Services for patient care duties.

· Reports to the Director of Hospice and Palliative Care