HCBA OCM RN Case Manager - San Jose

OCM RN Case Manager

Position: OCM RN Case Manager

Pay Range: $95,000 -$105,000 PER YR

Reporting To: Lead OCM RN Case Manager

Work Type: Remote

Position Summary:

The OCM RN Case Manager is responsible for the clinical care and coordination of services provided to patients in their home or place of residence. This includes providing clinical services, such as comprehensive assessments, administration and management of medications or performing treatments ordered by the physician, identifying, organizing, coordinating, and monitoring services needed by a recipient.

Qualifications:

• Must have a current, unsuspended, un-revoked license to practice as a Registered Nurse in California.
• Knowledge of the current Nursing Practice Act.
• Possesses current CPR certification.
• Proficient in the use of computers.
• Minimum two (2) years' experience in a home health organization, primary care clinic, or a health facility. One (1) year experience in healthcare quality management preferred.
• Current and satisfactory report on pre-employment physical examination including TB Screening Test or chest X-ray as required by Agency policies and procedures. Must be free from signs of infection and illness.
• Exercises excellent judgment and possesses knowledge of current nursing practices, with demonstrated exemplary clinical, analytical, and documentation skills.
• Possesses good written and verbal communication skills. Fluent in English.
• Must be a licensed driver with an automobile that is insured and is in good working order, in accordance with state and/or organizational requirements.
• Familiarity with Title 22

Essential Duties and Responsibilities:

• Provides nursing services, as part of the Case Management Team, for each assigned caseload and client.
• Ensures proper tracking, charting, progress notes and case records for each enrolled client within time guidelines and assures completion according to Agency's policies and procedures. Documents patient intervention and response for accurate intervention using established guidelines.
• Ensures proper timekeeping and scheduling, as discussed with supervisor.
• Works collaboratively with the Social Worker on their Case Management Team (CMT).
• Completes assessments and reassessments based on the timeline determined upon a participant's enrollment in the program.
• Follow up with the participant after emergency and inpatient facility admission.
• Reports all incidents and issues that arise before, after or during an assessment to the lead RN.
• Maintain all scheduled visits on the calendar.
• Review all documents associated with the applicant to be prepared before completing assessment.
• Completes all assessments within the outlined timeframe which is stated in the HCBA policy and procedure handbook.
• Manages complaints from clients, families or friends.
• Reports all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or neglect occurs in an RCFE) or DHCS and APS (if abuse or neglect occurs in PH). Reports fraud.
• Reviews the Significant Incident Reports (SIRs) with client and staff, as necessary.
• Participates in Education, Training and Quality Improvement Activities. Monitors compliance and assists Agency in maintaining compliance with Federal, State, Local, and HIPAA Regulations, as well as Joint Commission Standards and Labor Laws.
• Screens applications/applicants for HCBA Waiver to determine if the applicant meets the minimum HCBA Waiver LOC eligibility requirements.
• Schedules and conducts comprehensive health and psychosocial assessments of participants' medical needs, diagnosis, functional and cognitive abilities, and environmental and social needs, to determine which service(s) are required to meet participants' needs and preferences in the community. Works with MSW to perform initial evaluations and works with applicant, his or her legal representative, circle of support, physician and providers to develop a Plan of Treatment to:
• Develop goals associated with the participant's assessed needs, individual circumstances, and preferences.
• Mitigate risk and minimize disruptions in services.
• Identify when services outlined in POT are available through friends, family, and/or publicly funded programs.
• Implement the POT, which includes identifying service providers and community resources to help assure the timely, effective, and efficient mobilization and allocation of services.
• Identify (and train, if necessary), backup caregivers who are willing and able to provide unpaid support if waiver service providers are not available.
• Provide information, education, counseling, and advocacy to, and on behalf of, participants.
• Provides information, education counseling, and advocacy to, and on behalf of participants.
• Monitors the delivery of HCBA Waiver Services to ensure participants are receiving services as authorized in their POT's.
• Respects the patient's and family's rights and property as defined by the federal and state laws.
• Always maintains and conserves confidentiality of patient and agency information conforming to HIPAA regulations.
• Regularly attend and participate in scheduled case conferences, staff meetings and Agency in-services (in person, by phone, or by web).
• Participates in appropriate continuing education as may be requested and/or required by immediate supervisor.
• Regularly self-assess nursing skills and educational needs to meet the nursing care requirements of patients assigned for care. Upgrades professional skills and attends in-services and continuing education classes as needed.
• Attending all State mandated in-service trainings.
• Conforms to all agency policies and procedures.
• Provides Agency of current licensure for RN. Maintains licensure and provides Agency proof of such.
• Maintain all required credentials up to date.
• Familiarity with Title 22.
• Maintains comfortable work environment for all employees.
• Maintains constant communication with department team.
• Enhances efficiency and productivity of procedures and employees.
• Maintains positive customer satisfaction/service.
• Significant amount of driving may be required throughout LA, Fresno, San Bernardino and Ventura County.
• Performs other duties as assigned.

Physical Requirements:

• Stand, sit, talk, hear, reach, stoop, kneel and use of hands and fingers to operate computer, telephone, and keyboard on a frequent basis (up to 75% of the time).
• Close vision requirements due to computer work.
• Light to moderate lifting may be required (Up to 25lbs).
• Some driving/traveling may be required up to 25% of the time.