Job Summary:

A Registered Nurse who is responsible for planning, coordinating, providing and documenting care for a geographically assigned caseload of patients from day of admission through day of discharge. Utilizing physicians’ orders and professional skills, the RN Case Manager develops and implements a home health plan that meets each patient’s specific needs and is in compliance with federal and state regulations, reimbursement guidelines, as well as Agency policies and procedures.

Responsibilities:

• Performs admission assessment within 24 hours of referral or patient’s return to his/her residence.
• Develops a written plan of care for each patient in the assigned geographic caseload.
• Assesses patient’s condition, initiates plan of care, re-evaluates and updates as necessary.
• Ability to adequately assess and reassess pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management.
• Performs patient care responsibilities considering needs specific to the standard of care for patient’s age.
• Demonstrates knowledge of medications and their correct administration based on age of the patient and patient’s clinical position.
• Follows the five (5) medication rights and reduces the potential for medication errors.
• Provides skilled nursing care.
• Obtains all necessary physician orders and collaborates with physician as patient’s needs dictate.
• Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.
• Initiates case conferences to discuss multidisciplinary team responsibilities, patient progress, plans for continued care, new problems, etc.
• Notifies the Intake Coordinator of patients who need to be seen on weekends or holidays and submits updated nursing care plan to the weekend/holiday nurse.
• Follows up with obtaining lab results and notifying physician of any significant results.
• Establishes patient schedule and indicates which patients may be seen by a part-time RN when caseload prohibits Case Manager from seeing all scheduled patients.
• Re-evaluates the need for continued care on an ongoing basis; initiates recertification as necessary.

Qualifications:

• Graduate of an accredited school of nursing. 
• Current state licensure as a Registered Nurse.
• Experience as an RN commensurate with one of the following:
• One (1) year acute care experience within the last two (2) years;
• One (1) year home healthcare experience within the last two (2) years;
• One (1) year community health or public health experience within the last two (2) years;
• One (1) year outpatient facility experience within the last two years;
• Credentials in specialty area, i.e., phlebotomy, IV, ET.
• Current health certificate/physical examination and TB testing.
• Full command of verbal and written communication skills.
• Demonstrated leadership capabilities with the ability to relate well to staff and other professionals