Lead RN in San Marcos, California at Palomar Health Palliative & Hospice

Position: Lead RN

Reports to: Sr. Director of Clinical Operations

Department: Clinician

FLSA: Non-exemptJob type:

Full-timeTravel: 35%

Position Summary

The Lead RN serves as a critical clinical and operational leader, balancing supervision/mentorship responsibility for their team with the active delivery of high-quality, compassionate patient care. This role acts as the primary liaison between the clinical staff, patients, families, and the Director of Patient Care Services. The Lead RN is instrumental in ensuring compliance with clinical policies, driving the overall Quality Assurance and Performance Improvement (QAPI) Programs, and is a resource and mentor to field clinicians while promoting consistency in clinical practice, and assists with care coordination across the interdisciplinary team (IDT).

Responsibilities

Clinical Leadership & Mentorship

• In conjunction with the Director of Patient Care Services & DPCS Designee, serve as a clinical resource and role model, providing guidance and problem-solving support to the nursing staff.
• Mentor team members to maximize their patient care skills and ensure the delivery of high-quality, compassionate care.
• Facilitate interdisciplinary team meetings, ensuring effective communication and alignment on patient care goals.
• Lead and participate in training and in-service education for clinical staff to foster professional growth and compliance.
• Act as a key communication link between field staff, patients, families, and the Director of Patient Care Services.
• Drive consistency in clinical practice across the team by developing and reinforcing best practices.
• Serve as the primary clinical escalation point for complex patient care issues or operational challenges.

Direct Patient Care & caseload management

• Actively deliver high-quality, compassionate patient care, including clinical assessments, interventions, and care coordination across the interdisciplinary team (IDT).
• Provide expert-level pain and symptom management in collaboration with the physician and IDT to ensure patient comfort and quality of life.
• Perform comprehensive patient and family education regarding disease progression, medication administration, and end-of-life planning.
• Document all patient visits, assessments, interventions, and communication accurately and timely in the Electronic Medical Record (EMR) in accordance with Medicare hospice regulations and organizational standards.

Compliance & Quality Assurance

• Enforce and interpret hospice policies, ensuring strict adherence to local, state, and federal regulations.
• Monitor clinical standards and productivity, ensuring continuity of care and maintaining a safe working environment.
• Collect and analyze data to assist the Director of Patient Care Services in program planning and quality improvement initiatives.

Operational & Personnel Management

• Oversee the hiring, orientation, retention, and performance evaluation of the clinical team.
• Manage personnel actions, including discipline and counseling, to foster a motivated and high-performing workforce.
• Maintain budget requirements related to labor and clinical supply costs while ensuring operational efficiency.

Perform other duties as assigned.

Requirements:

• Active, unrestricted Registered Nurse (RN) license in the applicable state
• Minimum of 2 years of hospice, palliative care, home health, or acute care experience with 1 year in a lead or supervisory role preferred
• Strong knowledge of hospice eligibility criteria and Medicare hospice regulations
• Exceptional communication, interpersonal, and clinical judgment skills
• Ability to manage complex conversations with patients and families during emotionally sensitive situations
• Proficiency with EMRs and clinical documentation systems
• Valid driver’s license and reliable transportation

Preferred Qualifications:

• Prior hospice admissions or intake experience
• Prior experience leading and mentoring teams and overall performance
• CHPN (Certified Hospice & Palliative Nurse) or willingness to obtain
• Experience working in hospital-based or joint venture hospice models
• Bilingual skills (market-dependent)

Work Environment & Physical Requirements:

• Ability to perform job duties across a variety of settings, including patient homes, assisted living communities, skilled nursing facilities, and inpatient environments.
• Regular standing, walking, and driving between patient visits or work locations.
• Frequent bending, stooping, kneeling, and reaching while providing care or completing assessments.
• Ability to lift or assist with moving patients and equipment up to 50 pounds, with or without reasonable accommodation; additional support or equipment may be used for heavier transfers.
• Sufficient hand dexterity to complete clinical tasks such as administering medications, documenting in electronic systems, and using medical equipment.
• Visual and hearing ability to safely assess patients and communicate clearly with patients, families, and team members.
• Ability to respond appropriately in urgent or emergency situations, including performing CPR if required.
• Comfort working in a range of home environments, including exposure to pets, smoke, and varying indoor/outdoor conditions.
• Regular use of computers, tablets, and mobile devices for documentation, communication, and virtual meetings; ability to sit for extended periods while completing electronic charting and administrative tasks.
• Reliable transportation and ability to travel within the service area.
• Ability to manage the physical and emotional aspects of working in end-of-life care.