Home Health Registered Nurse, RN, Case Manager
$84.3k - $107.48kTufts Medicine Care at Home
Job Overview Utilizing the nursing process, the Home Health Registered Nurse will manage and deliver comprehensive home health services, including assessments, interventions, and supportive care to clients within their place of residence. Depending on the circumstances, duties may also include telephone triage, problem solving, patient/caregiver advocacy and support, with emphasis of avoiding hospitalization. As a key member of the health care team, this position must interact courteously and effectively with patients and their families as well as with coworkers from all Agency departments, community resources, and with patients' physicians in order to facilitate safe and efficient patient care while maintaining their own safety in the home and the community at large. Job Description Minimum Qualifications:
- Candidates must hold an active RN license in the state where services are provided and may not work in states where they are not licensed. If additional state licensure is required, it must be obtained within sixty (60) days.
- Valid state issued Driver's License.
- One (1) year of acute medical/surgical nursing experience.
- Basic Life Support Certification.
- If hired prior to 9/28/2026, CPR Certification is required upon hire. If hired after 9/28/2026, BLS Certification is required within thirty (30) days of hire.
- Bachelor of Science in Nursing (BSN).
- Specialty nursing certifications.
- Three (3) years of acute nursing including medical/surgical, oncology, hospice, or home health.
- Experience with IV and complex wound care.
- Assesses patients' physical, psychosocial needs in a sensitive, caring manner following established Standards of Nursing Practice and Agency policies and procedures. Provides ongoing interdisciplinary assessment of the patient.
- Assesses patient/family learning needs, style and limitations and makes adjustments for delivery of information.
- Recognizes/identifies patients/caregivers' cultural beliefs re: death and dying and is sensitive to those beliefs.
- Establishes realistic goals and develops plan of treatment in cooperation with the patient, family and members of the health care team.
- Identifies abuse and/or neglect and identifies reporting mechanism per policy.
- Adapts to new and unusual situations without affecting work performance negatively. Utilizes Security when and if needed for any potential unsafe situations.
- Collaborates with patient /family and other health care providers and/or community resources with planning of care and discharge.
- Continuously assesses/evaluates patient and family progress and goal achievement, keeping Clinical Manager advised and justifying continuation and/or termination of services.
- Documents patient data, activities, and communications in patient record using computer system in a timely, organized, concise manner to ensure compliance with legal, certification, third party payor guidelines and Agency policies.
- Completes physicians' orders, levels of care, and OASIS on all patients assigned, in accordance with patient care policies. Reconciles medications with patient and physician consistently.
- Demonstrates and practices according to safety guidelines and procedures including general ergonomics, fire, and personal safety. Utilizes proper body mechanics and patient material handling.
- Demonstrates an awareness of safety and security issues by responding appropriately to emergency situations and following established procedures and protocols utilizing stabilizing techniques.
- Demonstrates ability to cope with patient/family emotional stress and provide appropriate supportive care.
- Effectively manages assigned caseload, within the team model of care delivery. Establishes a daily work plan based upon patient/family priorities of service and total area needs. Promptly triages patient visits, messages, and phone calls according to priority and urgency.
- Provides nursing coverage on a rotating basis for evenings, nights, weekends and Holidays.
- Demonstrates excellent physical assessment and care planning skills. Demonstrates current knowledge of pharmacology and medication administration and reconciliation.
- Coordinates care and discharge planning with other team members during case conferences.
- Acquires and maintains an expert working knowledge of all third part payers and regulatory bodies and agency policies on issues related to documentation and care provided.
- Communicates and collaborates with all disciplines in the home care setting on a regular basis or immediately if there are any critical needs or crisis interventions needed.
- While performing the duties of this job, the employee is required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell.
- The employee must regularly lift and/or move 25 lbs and occasionally lift and/or move up to 100 lbs.
- The employee in this position frequently communicates internally and externally.
- Must be able to exchange accurate information via phone, email and/or in person.
- Specific vision abilities apply including close vision, distance vision and ability to adjust focus.
- Noise level in the work environment is usually moderate.
- May be exposed to weather conditions prevalent at the time.
- Demonstrates knowledge and skills necessary to provide care appropriate to the age of the patients served.
- Demonstrates competence in Home Health and Hospice standards of care, symptom management, psychosocial, and spiritual aspects of care.
- Excellent interpersonal skills with the ability to communicate, read, and write in English.
- Ability to function well, effectively manage time, and prioritize busy schedules.
- Good organizational skills.
- Ability to function effectively, autonomously, and independently in a home care setting.
- Ability to function effectively and autonomously in a home care setting.
- Competitive salaries & benefits
- Medical, Dental and Vision benefits start day one
- 403(b) retirement with company match
- Tuition reimbursement and continuing education support - Access to MedBridge for PT CEUs and licensure/certification support, reinforcing our commitment to ongoing clinical development.
- Opportunities for career growth
- Fleet car program - A unique offering that reduces personal vehicle burden and supports clinicians in the field.
- Industry-Leading Safety Program - A one-of-a-kind Workplace Safety & Violence Prevention role dedicated to proactively addressing increasing safety concerns in healthcare settings. This program includes:
- AVADE de-escalation and self-safety training
- InvisaWear GPS-enabled safety devices
- Escort services to ensure staff safety in the field
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