Home Health Care RN Case Manager

Job Description

Job Description

Registered Nurse – Case Management

Schedule

• Monday–Friday: 8:30 AM–5:00 PM
• On-Call: 6 days per month — 4 weekdays and 2 weekend days (Saturday/Sunday)
• Productivity: 30 units per 40-hour week
• Mileage Reimbursement: $0.43/mile

Service Area

This position will support patients throughout:

• Chatham County
• Liberty County
• Bryan County
• Effingham County

Position Overview

We are seeking an experienced Registered Nurse with a strong home health background to provide comprehensive case management and care coordination for high-risk patients. This role focuses on developing individualized care plans, coordinating services across healthcare providers, and helping patients achieve optimal outcomes.

Key Responsibilities

• Perform comprehensive assessments of high-risk members and continuously evaluate their clinical and functional needs.
• Collaborate with primary care providers to develop and implement individualized care plans.
• Identify appropriate, cost-effective levels of care and adjust services as patient needs change.
• Coordinate care transitions and ensure continuity of care between healthcare settings.
• Work closely with physicians, social workers, discharge planners, claims professionals, and other healthcare providers.
• Coordinate non-medical support services, including transportation and housing resources, to help patients follow their treatment plans.
• Engage specialty resources and community services as needed to support patient outcomes.
• Identify opportunities for health promotion, disease prevention, and early intervention.
• Monitor patients for potential adverse outcomes and intervene promptly when concerns arise.
• Maintain detailed documentation of clinical, functional, and financial outcomes throughout the case management process.
• Serve as a patient advocate while protecting patient privacy and confidentiality.
• Accurately complete required clinical and OASIS documentation.

Required Qualifications & Skills

• Active, unrestricted Georgia RN license.
• Associate's or Bachelor's degree in Nursing or a related field.
• Home health experience required.
• Proficiency with OASIS documentation and accuracy required.
• Hands-on experience with HCHB (Homecare Homebase) required.
• Ability to analyze complex medical information and make sound clinical decisions.
• Strong communication, organization, and care coordination skills.
• Case Management certification preferred/required based on client requirements.
• Ability to work independently while collaborating effectively with physicians and other healthcare professionals.