Community Care RN

Schedule : Exempt, min 40 hours | 8:00am – 4:30pm Department: Huron Valley PACE | Ypsilanti, Mi What You’ll Do in This Role: The Community Care Registered Nurse (RN) is responsible for providing both direct and indirect nursing care to PACE participants across the continuum of care. Working under the direct and indirect supervision of the Director of Clinical Services or designee, the RN practices independently while applying advanced nursing knowledge, clinical judgment, and skills.

This role manages complex clinical situations, coordinates care, and assumes accountability for participant outcomes to support safe, high-quality, and person-centered care. Assessment Conduct nursing assessments and complete required documentation in accordance with PACE standards. Triage participant concerns by phone and determine appropriate interventions.

Perform fall risk and other required clinical assessments. Identify participant needs, set priorities, and initiate referrals or follow-up as needed. Interpret and document diagnostic results using sound clinical judgment. Participate in IDT meetings and contribute to participant care planning. Complete in-home assessments for prospective participants as assigned.

Planning Care Complete initial, semi-annual, and annual nursing assessments prior to IDT meetings. Develop and update individualized care plans using the nursing process and interdisciplinary input. Collaborate with participants and families in care plan development. Communicate changes in participant condition to the IDT in a timely manner.

Implementing & Managing Care Provide nursing care in accordance with professional standards and organizational policies. Administer prescribed treatments and procedures, including IV therapy, tube feedings, and wound care. Manage medications, including reconciliation, coordination with pharmacy, and participant education.

Educate participants and families on coordination of 24-hour care services. Respond to emergency situations and initiate appropriate nursing interventions. Coordinate participant care across settings, including tracking hospital admissions and discharges. Ensure accurate, timely documentation and report infections per established protocols.

Conduct home visits and participate in after-hours on-call rotation as assigned. Leadership Follow clinic workflows and participate in meetings and huddles as directed. Delegate nursing care appropriately and support team collaboration. Participate in Quality Improvement initiatives and promote safe, cost-effective care practices.

The above is a summary of the position, it in no way states or implies that these are the only duties you will be required to perform. If selected for the position you will receive a full job description. Required Qualifications Graduate of an accredited School of Nursing. Current Registered Nurse (RN) license in the State of Michigan.

CPR certification required (or ability to obtain upon hire). Valid Michigan driver’s license with reliable transportation. Ability to lift and move up to 35 pounds independently.

Preferred Qualifications

Three (3) years of nursing experience in a healthcare setting. At least one (1) year of experience working with the frail or elderly population. Career Growth & Development – Advance your career with tuition assistance and school scholarships up to $3,000 per semester. Wellness Program & Reimbursemen t – Prioritize your health and well-being, reimbursed 120 a year!

Competitive Benefits for Full-Time Team Members – Enjoy Medical, Vision & Dental Insurance starting on the 1st of the month after 30 days of hire. Retirement Savings Plan – Secure your future with employer contributions. Generous 6 weeks of Flexible time off per year —plus paid holidays on top of that. Team Member Referral Bonus Program – Earn $500 when you bring great people to our team!

Mileage Reimbursement – Offered for work-related travel. #