Health Home Registered Nurse Case Manager

Job Summary We are seeking a dedicated and compassionate Health Home Registered Nurse Case Manager to join our team. The ideal candidate will possess extensive clinical expertise, including inpatient and outpatient experience across various healthcare settings, and a strong commitment to patient-centered care. As a vital member of our health services team, you will coordinate comprehensive care plans, facilitate effective communication among providers, and support patients in achieving optimal health outcomes through proactive case management.

Essential Duties:

1. Attendance for reliability for clients to receive uninterrupted services 2. Provides skilled nursing care under physician orders. 3. Provides nursing assessment, develops and executes plan of care interventions, evaluates responses to interventions for each individual patient and updates physician/plan of care as needed to gain positive outcomes. 4. Promotes, maintains, and restores health through teaching, counseling, and use of appropriate preventative, rehabilitative and /or palliative measures, and with ongoing observation and assessment of response. 5. Collaborates with the patient's physician regarding the plan of care and arranges/assures the Face-to-Face Encounter with PCP is completed as required. 6. Works with billing to manage timely documentation for the purpose of attaining insurance authorization timely. 7. Assures quality of care is maintained and client's needs are appropriately met. 8. Maintains and completes accurate documentation in timely manner. a. Point of care documentation will be completed with the expectation that at least 80% of the documentation is done in the patient's home. b. Admission/Recertification/Resumption of Care/Significant Change in Condition assessment visits should be completed and synced into database within 24 hours. c. Transfer/Discharge visits should be completed and synced in on the same day. d. Subsequent visits should be completed and synced in on the same day. 10. Participates in case conferences and/or IDT meetings 11. Attends staff meetings and educational programs as required. 12. Follows State and Federal Regulations for Home Health and Hospice 13. Follows all safety policies and procedures. 14. Case manages Home Health needs of 25-30 patients to provide a safe care plan, using all available agencies and community resources. 15. Completes 5-6 visits per day, on the average. 16. Delegates personal care or homemaking duties to home health aides and homemakers. Participates in instruction, supervision and evaluation of aides and homemakers. 17. Delegates visits to LPN. Participates in hand-off, instruction, supervision, and evaluation of LPN. 18. Assists with Quality Assurance Performance Improvement (QAPI) and Process Improvement Projects (PIP) as requested 19. Demonstrates commitment to agency security policies, including: proprietary information, HIPAA, and other state/federal security expectations. 20. Demonstrates alignment of agency Mission, Vision, and Values. 21. Other duties as assigned Join our team as a Health Home Registered Nurse Case Manager to make a meaningful difference in the lives of our patients through expert care coordination and compassionate service!

Pay:

$42.00 - $46.00 per hour Expected hours: 40.0 per week

Benefits:

403(b) matching Dental insurance Disability insurance Employee assistance program Flexible spending account Health insurance Life insurance Mileage reimbursement Paid time off

Work Location:

In person