Case Management

• (Registered Nurse) Coverage Area
• Worcester County Resolution Home Care LLC West Boylston, MA Job Details Full-time $30
• $42 an hour 9 hours ago Qualifications Bilingual Collaborate with healthcare professionals Patient follow-up care Care plan evaluation Nursing Patient progress tracking Patient resource coordination Caregiving documentation requirements RN License Initial assessment (medical evaluation) Quality of care (regulatory compliance area) Health insurance policy knowledge Regulatory compliance HIPAA Care documentation Diagnostic evaluation Clinical case management Managing patients as a nurse case manager Clinical audit and monitoring Transitional care planning in clinical case management CMS regulatory compliance Supervising experience Medicare regulations Team management Care coordination meetings experience Centers for Medicare and Medicaid Services (CMS) Clinical assessment documentation Health record tracking Patient family and caregiver education Multidisciplinary team collaboration for treatment planning Full Job Description Job Summary Resolution Home Care, LLC is a CHAP-accredited home health agency committed to delivering high-quality, patient-centered care throughout Massachusetts.

We work closely with patients, families, physicians, and interdisciplinary teams to ensure safe, compliant, and compassionate care in the home. We are currently seeking a dedicated Case Manager to join our growing clinical team. Position Summary The Case Manager is responsible for coordinating and managing patient care services, ensuring compliance with MassHealth, Medicare, and agency policies. This role involves conducting assessments, developing and monitoring care plans, collaborating with clinicians, and advocating for patient needs across the continuum of care. Duties Conduct thorough patient assessments, including vital signs, medical history review, and physiological evaluations to determine care needs. Develop and implement individualized care plans in collaboration with healthcare professionals across hospital, outpatient, and post-acute settings. Manage clinical case management activities such as discharge planning, home health coordination, and post-acute care arrangements to optimize recovery and reduce readmissions. Utilize electronic health records (EHR) systems to document patient information accurately while maintaining strict adherence to HIPAA regulations for patient privacy. Coordinate with multidisciplinary teams including physicians, social workers, therapists, and community resources to ensure comprehensive patient support. Oversee utilization management by evaluating diagnostic evaluations, medical necessity, and appropriate resource allocation for inpatient and outpatient services. Provide expert guidance on medical terminology, health regulation policies, and infectious disease care protocols to ensure compliance and quality standards are met. Requirements Valid RN license with current registration in the state of practice. Conduct ongoing assessments, reassessments, and discharge visits as assigned, ensuring continuity of care and timely identification of changes in patient condition Develop, implement, and update individualized Plans of Care (POCs). Ensure POCs are accurate, person-centered, and reflective of current clinical status. Coordinate services with RNs, therapists, physicians, caregivers, and families Monitor patient progress and outcomes, adjusting care plans as needed Ensure all documentation is accurate, timely, and compliant with regulatory standards Participate in interdisciplinary team meetings, case conferences, and QAPI activities Educate patients and families on available services, care plans, and community resources Maintain compliance with CHAP, MassHealth, Medicare, and agency policies Perform supervisory visits in accordance with regulatory requirements to evaluate the quality and appropriateness of services provided by clinical and paraprofessional staff Join us in delivering exceptional patient-centered care through expert case management! We value energetic professionals committed to improving health outcomes by leveraging their clinical expertise in a fast-paced environment that fosters growth and collaboration.

Pay:

$30.00

• $42.

00 per hour People with a criminal record are encouraged to apply

Work Location:

In person