RN Case Manager

Overview Preferred Certified Home Care is looking for an experienced RN Case Manager to manage and oversee the home care services provided to our patients. Previous CHHA experience with OASIS documentation is strongly preferred. Responsibilities Apply age-specific criteria as appropriate. Responsible for the assessment and treatment for patients of all ages, including neonates, children, adolescents, adults and geriatrics. Understand cognitive, physical, emotional, and developmental needs for all ages; ensure care reflects these needs. Plan, implement, manage, and evaluate the provision of professional and ancillary home health services to meet patient needs and provide quality care in accordance with Federal, State, and agency guidelines. Establish and update the care plan with input from the patient/caregiver, physician, and other multidisciplinary health team members. Complete required documentation in a timely manner (interdisciplinary referral form, 485, OASIS, interim physician orders, coordination notes). Familiarity with MLTCP and commercial payer requirements for care. Manage the activity of the multidisciplinary team providing care and ensure all visits are authorized and covered by a physician order. Review reports, evaluate ongoing patient care needs, and communicate those needs to the physician. Contact and follow up with physicians and other care providers to assist with care coordination. Participate in staff and team meetings as required. Maintain an ongoing responsibility for assigned caseload and proficiency in clinical and administrative skills. Demonstrate sound judgment and independent problem solving to initiate appropriate interventions for psychosocial and/or physical impairment. Facilitate home-based care by utilizing community resources, counseling and teaching patient and family, and advocating on behalf of the patient. Communicate caseload and patient care issues to the Clinical Manager. Update the Home Health Aide plan of care and coordinate with the Home Health Aide Coordinator. Develop and carry out a discharge plan with the field team, patient/caregiver and health care team; interpret agency policy to patients and families. Ensure visits have prior authorization when required by the patient’s managed care insurer; work collaboratively with the insurer. Monitor the quality of therapeutic services through written and verbal communications with all disciplines; participate in performance improvement activities, team meetings, and orientation as requested. Participate in case conferences and clinical rounds to provide guidance and reinforce best practices. Participate in the agency’s Quality Assurance/Performance Improvement Program as designated or assigned. Collaborate with other Interdisciplinary Team members to develop interventions to achieve clinical and functional goals. Document accurately, timely, and completely in the patient’s clinical record in accordance with CMS/DOH regulations. Write accurate and concise clinical/progress notes reflecting the plan of care and patient response. Ensure actions taken comply with corporate compliance regulations and report any suspected violations to the supervisor or Compliance Officer. Perform other nursing activities as directed. Qualifications and Experience Graduate of an accredited school of nursing; BSN preferred. Current Registered Nurse license with NYS Department of Education required. Minimum of 1 year recent medical/surgical nursing experience required. Experience in long-term and/or acute care facilities preferred. Experience with MRDD patients and/or public/community health preferred. Familiarity with EMR and computer applications (Word, Excel) preferred. UAS certification also preferred. Benefits Life Insurance 401k + Company match Paid holidays PTO package Paid orientation Employee Referral Program Job Type: Full-time Pay: $110,000.00 - $120,000.00 per year EQUAL EMPLOYMENT OPPORTUNITY We are an equal opportunity employer. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, genetic information, or any other protected characteristic under federal, state, or local law. Reasonable accommodation is available per ADA and applicable state laws. #J-18808-Ljbffr