Registered Nurse - Home Care Case Manager

Registered Nurse Case Manager (RN)

Job Summary:

Provides professional services within the scope of nursing practice standards in collaboration with primary care physicians, teaches and educates patients and their families. This is an exempt position with salary based on experience, with additional wages based on weekly productivity.

Qualifications:

• Graduate of an approved professional nursing program (RN)
• Currently, licensed “in good standing” in Massachusetts.
• Minimum of one (1) year of experience as a professional nurse, preferably in home care.
• Must have a criminal background check.
• Must have current CPR certification.

Responsibilities:

• Receives the intake referral information and prepares paperwork/tools necessary for the visit.
• Obtains all pertinent medical history from patient, family or significant others.
• Performs home safety check and environmental assessment of the patient’s home environment.
• Performs the socio-psychological evaluation of the support systems available to the patient and documents necessary emergency contacts etc.
• Performs assessment visit and documents timely. (i.e. OASIS/ Skilled Nursing Note etc.).
• Performs physical examination and review of all body systems and documents such accordingly.
• Develops an appropriate and effective Plan of Care (POC) to be submitted to the physician for approval and implementation.
• Determines medical necessity for other services that could enhance the positive outcome desirable for the case.
• Evaluated the patient’s ADL and iADL abilities and therefore need of support services such as home health aide.
• Develops and implements the HHA plan of care when HHA services are ordered. Revises and signs this care plan the beginning of each certification period.
• Supervises the HHA in accordance with state/federal requirements and documents the supervision without having to be directed to do so.
• Orders “other” professional services that are effective and is willing adjust frequency of these services as outcome progresses and the patient’s condition warrants.
• Reviews billing processes with patient and/or family advising patient and/or family when co-pay or Medicare is not likely to pay for services (ABN).
• Effectively communicates with patient and family the POC and progression of such. Keeps the patient informed ongoing.
• Effectively communicates with other disciplines in the case (case conferencing) to effectively and appropriately problem solve as situations arise.
• Communicates effectively with the Director of Clinical Services or Nursing Supervisor scheduled visits planned and changes to the schedule on a weekly basis. Caseload is self scheduled but communication of the clinician’s schedule is essential.
• Communication with the patient’s physician (verbally and/or in writing) to obtain effective treatment modalities and/or rehabilitative therapy modalities to effect the best means to obtain the desired outcome for the specific medical problem that caused the case to open and/or recertify.
• Communicates in the case conferencing sessions to establish best practices for the individual patient’s needs.
• Submits accurate, complete paperwork at the end of every week so that all medical records are intact and up to date. Uses the drop box if the office is already closed for the weekend.
• Submits ALL OASIS documentation within 48 hours of the OASIS visit, WITHOUT exception.
• Submits requests for re-authorization of “more visits needed” prior to third party insurers authorized number of visits expiring.
• Coordinates Community Services that may be available to the patient to assist in safe home care needs.
• Understands that the fiscal and clinical management of each case is directly linked to the success of his/her office. Assures that visits are not done that cannot be billed.
• Participates in the Performance Improvement Committee process as requested to do so.
• Performs clinical record reviews (CRR) per Agency policy in collaboration with the Nursing Supervisor. Submits the CRR timely.
• Participates in the monthly staff meeting as part of the requirements of the position. Adjusts visits on the staff meeting day to accommodate this important function.
• Participates in the planning, operation and evaluation of the nursing services of the organization.
• Maintains professional licensure and actively seeks out educational experiences to enhance the practice of home care nursing for her/him and the benefit of the patients serviced.

Pay: From $85,000.00 per year

Work Location: On the road

Salary : $85,000