RN - Case Manager

Registered Nurse Case Manager

The Registered Nurse Case Manager develops and revises treatment and discharge plans in conjunction with the patient, family, physician, care delivery team, and third-party payors. Responsibilities include obtaining medical orders and approvals for medical services. OASIS assessments, reassessments, transfers, resumptions of care, discharges, and significant changes in condition must be completed and submitted in accordance with agency-defined time frames. The RN processes orders and notifies physicians of patient needs and changes in condition. Certification and recertification orders, as well as discharge summaries, are to be completed by the RN. Maintaining an environment that promotes respect for patients, privacy, confidentiality, and property is essential. The RN initiates appropriate preventive and rehabilitative strategies. Providing services that require specialized nursing skills is part of the role. Consultation and education regarding disease processes, self-care techniques, and preventive strategies are required for patients, families, and other team members. Supervision of Licensed Practical Nurses to ensure patient health, safety, and compliance with the plan of care is necessary. The RN directs, coordinates, evaluates, and supervises the quality of patient care services provided by the home health agency. Interaction with patients, physicians, referral sources, and others should foster continued positive relationships. Support of the care management philosophy includes collaborative customer-focused planning and case management designed to meet individual health needs. Ensuring compliance with state and federal legislation through the completion of appropriate clinical records is critical. Knowledge of available community-based services should be maintained. Flexibility and willingness to visit patients based on need rather than geography is important. Problem resolution at the point of contact must be ensured. Authorization and release of information forms should be signed by the patient or responsible party. The RN attends patient care conferences for assigned patients. The RN participates in achieving operational and financial objectives by monitoring progress and taking corrective action on quality indicators. Understanding the impact of the RN function on patients and other care providers is essential. The RN must pursue efforts to reduce or eliminate avoidable costs and errors. Response to findings from quality management reviews and audits is required to ensure resolution of potential problem areas. Participation in peer review and quality assessment and performance improvement activities is needed. Maintaining productivity requirements is part of the job. The RN ensures that visit authorizations are in place and that documentation reflects the medical necessity for home care services. Contributing to an environment of professional growth, learning, and mutual respect for all employees is expected. Recognition, respect, and celebration of workforce diversity should be promoted. Participation in education and training programs for self-development is necessary. The RN is responsible for key performance indicators established by management. Other duties may be assigned as requested.