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Position Overview

We are seeking a compassionate and skilled Advance Care Planning Nurse to join our cardiac care team in Nashville, TN. This PRN position offers the opportunity to make a meaningful impact on patients' lives by facilitating important healthcare planning conversations and ensuring their wishes are documented and honored.

In this role, you'll utilize Affirm Health's ACP technology platform to conduct meaningful advance care planning conversations with cardiac patients, document their care preferences, and ensure these preferences are translated into actionable medical orders. The platform identifies high-impact opportunities and provides clinical context to guide these important discussions.

Key Responsibilities

• Patient Engagement & Scheduling

• Coordinate and prioritize ACP conversations for cardiac patients based on clinical needs and provider referrals

• Conduct tailored, stage-appropriate ACP discussions based on each patient's condition, prognosis, and need

• Clinical Communication

• Assess patients' understanding of their health conditions and disease progression

• Guide patients through thoughtful exploration of healthcare preferences and treatment goals

• Provide education about advance care planning options and available resources

• Documentation & Compliance

• Document comprehensive treatment wishes using the Affirm Health ACP Tool

• Guide patients through the continuum of advance care planning, from initial preferences to formal medical orders when appropriate

• Prepare Physician Orders for Scope of Treatment (POST) forms for physician review and completion

• Ensure proper medical billing code documentation (1123F, 1124F, 99497, 99498)

• Maintain detailed records of all patient interactions and follow-up plans

• Care Coordination

• Collaborate with clinical teams for appropriate review and sign-off of documentation

• Identify patients who would benefit from transitions to home health, palliative care, or hospice

• Initiate appropriate referrals and coordinate with support services

• Quality Improvement

• Participate in continuous improvement of ACP workflows and conversation guides

• Provide feedback to Affirm Health on tool functionality and enhancements

• Collaborate with the clinical team to optimize ACP processes

Required Qualifications

• Current, active Tennessee RN license (required)

• Minimum 3 years clinical nursing experience, with at least 2 years in cardiology or other settings requiring sensitive communication

• Previous experience with advance care planning, hospice, palliative care, or care management strongly preferred

• Strong knowledge of Tennessee advance care planning regulations and POLST/POST forms

• Experience with electronic health records (athenaClinicals preferred)

• Demonstrated ability to facilitate difficult conversations with empathy and professionalism

• Familiarity with value-based care models and quality measures

• Proficiency with healthcare technology platforms and ability to learn new software systems (will use Affirm Health ACP Tool)

Essential Skills

• Exceptional communication and active listening abilities

• High emotional intelligence and cultural sensitivity

• Strong organizational skills and attention to detail

• Ability to work independently while collaborating with interdisciplinary teams

• Flexibility to adapt to varying patient loads and scheduling needs

• Proficiency with technology and willingness to learn new digital tools

• Strong documentation skills with attention to detail

• Comfort discussing sensitive end-of-life topics with patients and families

Work Environment

• Variable PRN schedule based on patient census (typically 3-5 days per week)

• Primary location: Cardiac clinic in West Nashville

Compensation & Benefits

• Competitive PRN hourly rate

• Access to continuing education opportunities

• PRN benefit eligibility per Ascension guidelines