Job description

RN Case Manager

Overview

Provides, coordinates, and directs the provision of home health nursing services and case management processes according to the assigned patients individualized plan of care based on agency policies and procedures, through the competent application of nursing process.

Responsibilities

1. Demonstrates knowledge of home care and competency in discipline specific patient care skills, required by the care center for the provision of patient care.

2. Performs patient comprehensive assessments and collaborates with patient multi-disciplinary care team (PT, OT, ST, MSW, and paraprofessionals) and other health care professionals to

1. develop/modify and implement an individualized patient plan of care as per physician orders that ensures quality, proper discharge planning and achieves desired outcomes and goals.

3. Implements appropriate nursing clinical programs and initiatives to achieve desired outcomes.

4. Provides clinical episode management according to Amedisys processes including oversight of patients individualized plan of care and care plan changes as deemed necessary by patients status or physicians ordered care.

5. Utilizes a combination of agency resources and nationally recognized standards of practice to deliver high quality care and achieve excellent patient specific outcomes.

6. Makes referrals to other disciplines as indicated by the patient’s identified needs or documents rationale for not doing so.

7. Promotes and maintains patient health and independence through teaching and appropriate rehabilitative measures, assisting patients in learning appropriate self-care techniques. Advocates and ensures patient participation in care planning and goals of care.

8. Supervises caseload including LPNs and Home Health Aides. Facilitates care coordination with PRN staff when care is provided for caseload.

9. Completes documentation timely, accurately, and at the point of care, according to industry standards, conventions, and guidelines, including OASIS assessments, SOC/Admissions, Recertifications, ABNs, subsequent visits, physician orders, care coordination etc.

10. Helps to achieve and maintain continuity of patient care by communicating information (for example, changes in plan of care, new orders, lab results, etc.) timely, effectively, and systematically with all team members providing care for the patient including PT, OT, ST, MSW, paraprofessionals, physicians, family members and community resources. Facilitates interdisciplinary communication and follow up through care coordination on assigned caseload for duration that patients are on service.

11. Participates in Team/Case Conferences. Leads discussion on multidisciplinary cases as appropriate.

12. Maintains ongoing communication with clinical manager regarding progress of patients for assigned caseload.

13. Remains knowledgeable of organizations quality improvement programs, participates in agency performance improvement initiatives and incorporates into patient care planning as appropriate.

14. Demonstrates competency in skills for required patient care. Initiates, plans and provides staff education, and performs competency and skills validation for care team staff, such as LPNs, HHAs and RN visit staff.

15. Utilizes a combination of care center resources and recognizes standards of practice to achieve positive clinical and training outcomes.

16. Utilizes accepted Amedisys teaching materials for clinician and patient/family education.

17. Performs on-call responsibilities and on-call services to patients/families as assigned.

18. Monitors assigned cases to ensure compliance with requirements of third-party payers.

19. Protects, honors, and respects patient and co-worker confidentiality and right to privacy.

20. Stays informed of industry knowledge and nursing best practice standards.

21. Participates in clinical development and continuing education programs.

22. Performs other duties, as assigned.

Required-

• Current, unencumbered license to practice as a Registered Nurse specific to the state(s) the employee is assigned to work/cover for the company. May possess either a single state license in each non-compact state and/or a compact license in their state of residence that is accepted in all Nurse License Compact (NLC) participating states.
• Nurse License Compact (NLC) documents the following: The mutual recognition model of nurse licensure allows a nurse to have one license (in his or her state of residency) and to practice in other states (both physical and electronic), subject to each state practice law and regulation. Nurses must legally reside in an NLC state to be eligible to have a multi-state license. See list of Nurse Licensure Compact States (NLC).
• Current CRP certification.
• One (1+) year of clinical experience as a Registered Nurse (RN). If less than 1 year clinical experience as a RN, candidate must be approved by VP Clinical. *
• Demonstrated knowledge of the appropriate skills for communicating with individuals of all ages. Excellent interpersonal skills including verbal and written communication skills.
• Demonstrates knowledge of Federal/State rules and regulations, ACHC standards, and other regulatory requirements.
• Valid Driver’s License.
• Reliable transportation and agency required liability insurance.
• Must be familiar with general use and functions of the computer, such as, usernames, password concepts, internet, email, navigation of computer desktop, including starting programs, using files, and windows, effective use of navigation buttons and tool bars, ability to self-manage online HR services and online training programs.

State Specific Qualifications:

Refer to the Registered Nurse State Matrix click HERE.

*Note - If less than 6 months clinical experience as a RN, candidate must participate in RN Intern program

Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.Responsible for the supervision, management, coordination and provision of quality patient care while demonstrating fiscal responsibility and maintaining the highest standards of care and ensuring compliance with all policies, procedures, and regulatory requirements. This role also accountable for measuring, monitoring, and managing quality of patient care, achievement of key performance indicators and organizational clinical performance.

Responsibilities

Develops, plans, implements, analyzes and organizes clinical operations for the care center.

Reviews requests for services and determines patient eligibility and suitability for home care services. Works with intake in coordinating patient referrals and admissions.

Oversees scheduling activities to ensure patient needs are met. Reviews assignments as appropriate with the patient services coordinator and professional and support staff.

Oversees payor verification and pre-certification requirements. Communicates with payors and their representatives with updates and responds to requests for information.

Responsible for review of documentation of other staff members including the Oasis data collection, starts of care, re-certification, physician orders, daily progress notes and other related documents ensuring appropriateness of care, delivery and documentation requirements are met. Ensures missing, incomplete and/or untimely documentation issues are resolved.

Oversees and assists clinicians in establishing immediate and long-term patient goals, setting priorities and developing Plan of Care (POC). Responsible to oversee the management and delivery of patient care, including utilization management, episode management and patient outcomes. Oversees the assignment of the appropriate clinical pathways and implementation of the plan of care and physicians’ orders for patients.

Oversees clinicians in the provision of care and services requiring substantial and specialized professional skills set (per applicable discipline practice act and standards of practice) and in accordance with the plan of care signed by the physician.

Oversees the professional staff to ensure timely communication of changes in the patient condition to the physician and receipt of necessary changes in orders. Ensures communication of changes in the plan of care to the appropriate staff.

Evaluates, and regularly re-evaluates the needs of the patient; initiates, develops, implements and makes necessary revisions to the patient’s plan of care in collaboration with the clinicians providing care.

Leads regular patient care conferences and promotes coordination and communication of information relevant to the care of the patient to ensure quality of care.

May provide direct patient care on an infrequent basis and only in times of emergency.

Participates in on call process, including admin on call, preparing on call schedule, supporting the on-call process.

Participates in agency quality assurance activities designed to improve quality and continuity of patient care. Performs chart audits and other activities of data collection.

Responds to Additional Documentation Requests/Denials as directed by the regulatory affairs department.

Assists with and coordinates training of appropriate staff to ensure quality care, compliance, and fiscal responsibility.

Instructs and guides clinicians to promote effective performance and delivery of quality home care services and is always available during operating hours to assist clinicians as appropriate.

Assists other disciplines in coordinating activities when necessary, assuming responsibility for continuity, appropriateness and quality of services delivered.

Monitors and evaluates employee performance, including through on-site evaluations. Holds employees accountable for the attainment of defined goals and objectives. Executes effective performance redirection and corrective action when needed. Develops employees through coaching, mentoring, and formal/on the job training and development opportunities.

Works cooperatively with the Director of Operations on addressing staffing, referral sources, physician and client concerns/needs. Documents incidents or errors involving schedule problems and/or any other concern as appropriate.

Participates in the investigation and resolution of patient/family/physician concerns.

Partners with operations and business development staff in meeting budgeted admission goals. Participates in sales and marketing initiatives.

Performs other related duties as assigned or requested.

Required-

• Associate or Bachelor’s degree in Nursing.
• Current, unencumbered license to practice as a Registered Nurse specific to that state the employee is assigned to work by the company.
• One (1+) years of supervisory and/or management experience as a Registered Nurse in a healthcare environment.
• One (1+) year of RN experience in a Home Health or Hospice environment.
• Current CPR certification.

Amedisys is an equal opportunity employer. All qualified employees and applicants will receive consideration for employment without regard to race, color, religion, sex, age, pregnancy, marital status, national origin, citizenship status, disability, military status, sexual orientation, genetic predisposition or carrier status or any other legally protected characteristic.

Job Types: Full-time, Part-time

Pay: $78,000.00 - $98,280.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Health savings account
• Paid time off
• Vision insurance

Medical specialties:

• Home Health

Schedule:

• 8 hour shift
• Day shift
• Holidays
• Monday to Friday
• Weekend availability

Work setting:

• In-person

Experience:

• Nursing: 1 year (Required)

License/Certification:

• RN License (Required)

Work Location: In person

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