Registered Nurse Case Manager

Our culture and people are what set us apart from other post-acute care providers. We're dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY. Schedule: Monday through Friday 8:30 am to 5:00 pm Company: The Christ Hospital Home Health Care SUMMARY The Registered Nurse Case Manager (RNCM) assumes ultimate accountability and leadership for the assessment of the patient condition and plan of care. The RNCM provides case management, clinical care and is responsible for coordination of all disciplines involved in providing quality, cost-effective and billable care through direct care and supervision of care under the direction of the physician. The RN educates patients and their family members and ensures the safety of the patient. The RN is accountable for completing accurate documentation and remains compliant with all legal rules and regulations. The RN is responsible for all practices and duties within the scope of practice as outlined by the state. KEY RESPONSIBILITIES Oversees the overall care of the patient from beginning to end of episode Updates all doctor orders in patient chart accordingly Notifies doctor of any significant changes of the patient's condition Manages multi-disciplinary care as applicable Provides skilled nursing care in a patient's home as ordered by the attending physician Observes and monitors patient conditions Performs OASIS assessments to develop an individualized plan of care and makes adjustments as needs change Administers medication as prescribed by the physician Helps decrease re-hospitalizations by front loading visits for high risk patients Promotes continuity of care with appropriate admissions, transfers and discharges Counsels patient and family on the disease/injury processes and how to manage Incorporates patient and family in development of plan of care Helps decrease re-hospitalizations by teaching the patient on preventative measures and making good decisions Listens to patient and family members Oversees and supervises total care of patient provided by nurse aides and LPNs Evaluates the treatments and medical condition of the patient according to the plan of care Determines if the level of care being provided meets the patients' needs Communicates with the LPNs and nurse aides on supervisory visit results Completes all clinical documentation in accordance with agency protocol and Medicare/Federal guidelines Documents all aspects of treatment, assessments, and patient education Maintains active RN license Communicates with scheduler any changes outside the normal Participates in all on-call requirements and case conferences Attends in-service trainings and mandatory agency meetings Drives to patient's primary location per scheduled visit. Daily attendance at assigned visit locations. Documents all aspects of subsequent, discharge, eval/recert/resumption of care visits within 24 hours of visits. Documents all aspects of start of care visits within 24 hours of visits. Completes and submits all required documentation within specified company requirements. Follows plan of care as permitted within the scope of practice for a Registered Nurse. Fulfills RN visits in assigned geographic location per patient need within federal and state specifications. Other duties as assigned. QUALIFICATIONS Minimum of one year of experience as an RN in an acute care setting. Home care experience is desired. Ability to effectively communicate and create positive impressions with patients, families, physicians and co-workers. Ability to remain calm, have patience and be accommodating. Compassionate and caring while working with patients. Knowledgeable on nursing best practices. Ability to make appropriate nursing judgments. Ability to identify a situation and handle it with the best possible solution. Detail-oriented and observant. Disciplined style of work ethic with the ability to prioritize and be timely. Ability to follow directions and work as a team member. Valid driver's license and auto insurance with your name as a listed driver. EDUCATION AND CREDENTIALS Registered Nurse with current license in the state of employment. We are an Equal Opportunity Employer. Post-acute care is at the center of improving health outcomes. We care for patients where they spend the majority of their time - in their homes. This privileged position allows us to see things that are invisible to a patient's primary care or hospital physician, and to deliver the best possible care tailored to each patient's setting. As the healthcare industry continues to evolve away from hospital-centric care, our work, caring for patients in their homes becomes more important than ever. Our success helping patients recover comes from engaging with them. We start at the facility bedside and coordinate each patient's transition back to their home, ensuring a smooth transition and that their care plan is right for them. We support complex, high-acuity, medically-at-risk aging patients. This is the most challenging group of individuals to serve, and we find it the most rewarding. And we do this all in partnership with health systems. Together we create a seamless care environment that enables patients to receive excellent care in the setting that best meets their needs. #J-18808-Ljbffr