RESPONSIBILITIES:

• Initial in home evaluations and/or assessment 
• Follow all Medicare COP's and State regulatory guidelines related to patient care
• Establish the patient’s individualized treatment and medical record baseline
• Collaborate with physicians, other agency staff and contract services to coordinate and implement the POC
• Supervise the implementation of the POC and the quality of care delivered to the patient
• Documents direct patient services, coordination and collaboration with physician and other disciplines or provides in the care of the patient, ensuring document is complete and timely to meets professional standards of practice, in compliance with state regulations and Medicare conditions of participation
• Reviews caseload charts documentation to ensure compliance assess patient progress and effectiveness of care delivery in meeting patient goals.
• Complies with all agency policies and processes related to documentation timeliness and accuracy.
• Timely and accurately complete all OASIS-E requirements
• Initiate patient plan of care and reevaluate as necessary
• Utilize health assessment data to determine nursing diagnosis
• Administer medication and treatment as prescribed by the physician in the plan of care
• Counsel the patient and family in meeting nursing and related needs
• Communicate with the physician and participate in interdisciplinary group meetings to meet the medical needs of the patient
• Additional responsibilities as assigned

QUALIFICATIONS/EDUCATION REQUIRED:

1. Registered Nurse with current state licensure
2. Minimum 2 years Home Health Experience

ABILITIES, SKILLS, AND KNOWLEDGE:

• Demonstrated understanding of the Medicare and Medicaid reimbursement system and thirdparty payers.
• Demonstrated expertise in coordinating work activities of multi-disciplinary team.
• Excellent oral and written communications skills with proven ability to communicate with technical and

non-technical users.

• Ability to read, analyze, and interpret common scientific and technical journals, professional journals, and legal documents.
• Ability to read and interpret physicians’ orders and notes from other caregivers as well as respond to them verbally and in writing.
• Ability to effectively present information to clients and employees and community members.
• Ability to respond effectively to the most sensitive inquiries or complaints.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Ability to send/receive emails and use the internet for research and informational purposes.
• Ability to use software to create a spreadsheet with minimal instruction.
• Ability to use word processing software for communication and documentation purposes.
• Ability to use independent judgment to manage and impart confidential information.
• Skill to attend to multiple tasks at once which are time sensitive.
• Basic knowledge of Windows operating system and ability to advance computer skills as required.
• Ability to establish and maintain effective working relationships with fellow employees and the public. 

SPECIAL REQUIREMENTS:

• Current TB skin test screening upon hire and screening annually thereafter. 
• Possession of a valid state Driver's License with reliable transportation and applicable car insurance if transporting patients. 
• Proof of COVID-19 Vaccination or approved medical or religious exemption.

PHYSICAL REQUIREMENTS: 

• Ability to regularly sit, stand, stoop, bend, kneel, walk, balance, crouch, crawl, push, pull, reach with hands and arms, and talk and hear.
• Ability to frequently use hands to finger, handle, or feel.
• Ability to occasionally climb.
• Ability to occasionally use sense of smell.
• Ability to frequently lift and/or move up to 50 pounds and occasionally lift and/or move 100 pounds.
• Ability to use close vision, distance vision, color vision, peripheral vision, depth perception.
• Ability to adjust focus.

WORK ENVIRONMENT: 

• The employee is frequently exposed to outside weather conditions.
• The work environment is highly variable, as care is provided in private homes.
• Lighting, acoustics, air quality, temperature and environmental hazards are not predictable.
• The employee is occasionally exposed to wet and/or humid conditions, household pets/animals, fumes, or airborne particles, and toxic or caustic chemicals.
• The noise level in the office work environment is usually moderate.

TRAVEL:

The employee is required to travel frequently to complete agency business.