Registered Nurse/Case Manager

Shift: Day 5×8-Hour (08:00 – 17:00)

Description:

**MUST HAVE HOME HEALTH EXPERIENCE AS A CASE MANAGER**

Required Certifications:
CA RN LICENSE
BLS

Experienced RN who is responsible for the overall management of patients, including the provision of direct care with a designated visit productivity standard. This position plans, organizes, and directs all patient care services for patients in the assigned caseload in accordance with current standards and regulations, ensuring the optimal degree of quality care is maintained. Responsible for coordinating the interdisciplinary team to implement the established plan of patient care and ensuring effective management of visit utilization and control of expenses. BLS from AHA. Radius from home office up to 35 miles.

*FROM THE MANAGER*
-Recent experience in home health NOT hospice.
-Case Management in hospital will not be what the job entails.

Performs routine assignments and develops competence by performing structured work assignments. Accountable for the assessment, coordination delivery and evaluation of in-home nursing care, including direct patient care, patient/family education and transitions of care. Delivers holistic and individualized care to all patients in assigned area. Develops, implements, manages/coordinates an optimal interdisciplinary plan of care that incorporates psychological, sociocultural, spiritual, economic, and life-style factors. Fosters and maintains collaborative relationships between patients, their family/support group, physicians, and other healthcare providers through timely and effective communications. Adheres to polices, industry standards, best practices, and applicable laws/regulations and codes to promote a quality, highly reliable patient experience. Engages in continuous growth and development in professional nursing practice.

JOB ACCOUNTABILITIES:ASSESSMENT AND PLANNING OF PATIENT CARE
• Conducts patient and family assessment encompassing physiological, spiritual and emotional areas.
• Collaborates and communicates with physicians and other members of the healthcare team to interpret, adjust, and coordinate in-home patient care plan to ensure a plan of care that is patient centric with continuity of care.
• Partners with peers, other healthcare providers, and management to effectively streamline patient workflow, improve patient outcomes, and provide the highest care quality
• Communicates patients’ plan of care to co-workers, physicians and other departments.
PROVISION OF PATIENT CARE
• Provides competent, compassionate and cost effective patient care in accordance with policies, scientific principles, evidence-based nursing practice/process, nursing objectives and standards of care.
• Maintains a safe, comfortable and therapeutic environment for each patient and their families/support group in accordance with regulations.
• Delegates tasks appropriately/effectively to team members based on legal scopes of practice, licensure, educational preparation, appropriate guidelines and individual capability.
• Communicates with and explains treatments/activities to patient and family in a clear, open- ended, collaborative manner showing care and concern, using teach back to ensure patient understanding of explanations, and integrating patient learning and educational needs.
• Maintains mindfulness in delivery of individualized care and in communication with patients and families, with a safety focu
s• Delivers safe and effective patient care in compliance with established policies and procedures, as well as local, state and federal regulations to provide the highest level of patient care.
• Upholds the confidentiality of all patient protected health information (PHI) and protects all PHI from accidental, intentional or inappropriate disclosure.
• Remains current in advancements, trends, and best practices related to acute care and area of specialty and in professional nursing practice.
EVALUATION OF PATIENT CARE
•Monitors patient care interventions, assesses therapies, evaluates outcomes, and intervenes as warranted.
•Conducts ongoing education for patients and their families to ensure optimal patient care from admission through transitions of care.
•Reassesses, evaluates and documents each patient’s response to the plan of care and adjusts the plan as needed.
•Reports any events or near-misses in safety or compliance concerns via patient safety reporting mechanism.
•Participates in analysis of safety events to prevent future occurrences.
•Accurately documents and updates all treatment information in the patient’s electronic health record (EHR).
•Develops, implements, documents formal teaching and transition planning that includes the patient/family in care for identified health needs