Complex Care Coordinator

NVNA and Hospice • Norwell, Massachusetts, United States • $67.04k - $93.69k / year • 1w ago

Why NVNA & Hospice?

Join a team that boasts an impressive track record of excellence in delivering top-tier home health, hospice, wellness, and public health services to our valued patients and community.

Our non-profit organization is a continued recipient of five-star patient experience ratings with the Centers for Medicare and Medicaid Services, the highest achievement possible. We are proud to be ranked as a Top 100 Women-Led Business in Massachusetts by Boston Globe Magazine and The Women's Edge.

In 2024, $6.5 million was raised towards our non-profit mission as we expand patient care access with continued philanthropic commitment from our community. Through the NVNA and Hospice Charitable Fund, in place for over a decade, more than $25 million has been raised for patient care.

Today, NVNA and Hospice is a vibrant agency serving 27 communities and providing 120,000 patient visits per year with a staff of 331—including 123 nurses—and a reputation for excellent care, efficiency, flexibility, and innovative thinking.

We continue to uphold our values of community, high-quality services in a safe environment of care, integrity, professional development, respect and caring, excellent customer service, and employee well-being. We are neighbors helping neighbors.

What will you be doing:

The complex care coordinator is responsible for oversight and guidance to the designated population of patients living with advanced or life-limiting illnesses. This role ensures that patients receive appropriate, compassionate, and timely services that align with their goals of care. The care coordinator works closely with interdisciplinary teams, patients, families, and external providers to manage complex clinical needs.

Key Responsibilities:

Participate in interdisciplinary case conferences and quality improvement initiatives.

Acts as an additional resource to patients by making wellness calls, follow-ups and coordinating with MD office as necessary.
Monitor patient status and proactively address changes in condition.
Identify any barriers to care transitions and communicate with other team members.
Collaborate with care team members, physicians and other providers to ensure continuity of care.

Maintain compliance with Medicare, Medicaid, and agency policies.

Skills:

Understands and is experienced in the regulations for Home Care.
Ability and experience working with and teaching home care staff on: (1) how to have a serious illness conversation with patients and families and (2) how to identify disease progression and how/when additional services such as Palliative or Hospice care might be appropriate.
Excellent customer service
Organizational skills, detailed-oriented and great follow-through is a must.

What we're looking for in you:

Current Massachusetts Nursing license in good standing
Registered Nurse (Bachelor's degree preferred)
2+ years of experience in home health, hospice, palliative care, or complex case management.
Strong understanding of serious illness trajectories, symptom management, and psychosocial support.
Familiarity with advanced directives, MOLST, and goals-of-care documentation.
Proficiency in EMR systems and clinical documentation standards.
Excellent communication, empathy, and decision-making skills.

What's in it for you?

Medical, Dental and Vison Benefits
Company paid Life Insurance and Long-Term Disability
Generous Paid Time Off Package
401 (k) match program
Tuition Reimbursement and Scholarship Program
Mileage Reimbursement (in field positions only)

VACCINE REQUIREMENTS: NVNA and Hospice requires full vaccination for Covid-19 and flu as a condition of employment. An exception to this mandatory requirement can be requested.

NVNA and Hospice complies with applicable federal and state civil rights laws and does not discriminate, exclude people or treat them less favorably because of race, color, creed, religion, national origin (including limited English proficiency and primary language), sex (including sex characteristics, including intersex traits, pregnancy, or related conditions, sexual orientation, gender identity and sex stereotypes), age, disability (including mental illness and substance abuse disorders), genetic material, veteran status, communicable disease, natural or protective hairstyles or any combination, thereof with regard to admission, access to treatment or employment.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.