RN Case Manager - Home Healthcare

SUMMARY

The RN Case Manager is responsible for overseeing the delivery of coordinated care for a patient and/or an assigned group of patients. Additionally, this position is responsible for the day-to-day management and supervision of the related clinical care activities within the area the Case Manager services.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following

Employee must have regular attendance/punctuality, be able to work with others at all levels of the Company, have exceptional customer service, and demonstrate a comprehensive in-home clinical knowledge base. Other assigned duties include:

• Provides accurate and complete documentation with rationale to ensure reauthorization of patients.
• Delivers services in the field or away from assigned office 50% of the time. Field activities include tasks such as: in-home RN scheduled visits, attending physician appointments.
• Assists in the implementation of the Plan of Care (‘POC’) and any amendments to the POC as needed.
• Conducts the orientation of new staff and coordinates them starting in patients’ homes.
• Serves as a resource to new staff for training and follow up after training to ensure staff satisfaction and retention.
• Submits all nursing documentation timely per company policy
• Completes assigned chart reviews as assigned within established time frames and follows up and councils’ staff on documentation issues as necessary and ensure documentation is turned in on time.
• Establish and promote a collaborative relationship with patient, physicians, payers, and other members of the healthcare team.
• Assist authorization team to collect and communicate pertinent, timely information to payers to ensure reauthorization of patient’s home health care services.
• Actively involved in the process improvement activities to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
• Participates in assigned quality assurance committee(s) and interdepartmental projects when needed or requested.
• Demonstrates current knowledge of Payor policy and procedure(s).
• Assist with state survey preparation and implementation and act as the backup administrator as assigned.
• Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

This position has direct supervisory responsibilities. This position will perform supervisory visits as needed.

Requirements

EDUCATION and/or EXPERIENCE

Required

• Associate's or Bachelor’s degree in a related field
• Current Registered Nurse (RN) license to practice professional nursing in each state where patient care is supervised
• Current Basic Cardiac Life Support and CPR certification
• At least three (3) years of experience as a Registered Nurse
• At least one (1) year of case management experience

Preferred

• Home health experience strongly preferred
• Department of Labor / EEOICPA experience preferred
• Supervisory experience preferred

Other Requirements: Maintain current state licensure. Maintain current liability and malpractice insurance, if applicable.

CERTIFICATES, LICENSES, REGISTRATIONS, & MEDICAL REQUIREMENTS

• Valid Driver’s License
• Active RN License

CLEARANCES The following background checks are conducted

• Criminal background
• Driving Record
• OIG Exclusion List
• Sex Offender Registry

#TFIND