About The Role

RN Home Health Case Manager

Responsibilities

Conduct comprehensive nursing assessments of patients' physical, emotional, psychosocial, and spiritual needs during admission, resumption of care, recertification, and discharge.
Develop, implement, revise, and evaluate individualized Plans of Care in collaboration with patients, families, physicians, and the interdisciplinary team (IDT).
Deliver direct skilled nursing care, including wound care, medication administration and management, IV therapy, injections, symptom management, and patient/caregiver education.
Perform accurate and timely OASIS assessments to ensure proper reimbursement, quality reporting, and optimal patient outcomes.
Educate patients and their families/caregivers on disease management, medication adherence, safety measures, self-care techniques, and strategies to prevent re-hospitalizations and promote independence.
Supervise and direct LPNs/LVNs, home health aides, and other support staff to ensure coordinated, high-quality care delivery.
Monitor patient progress, promptly identify changes in condition, and adjust care plans accordingly to optimize outcomes.
Maintain accurate, timely clinical documentation in the Electronic Medical Record (EMR) system in compliance with agency policies, OASIS guidelines, and all regulatory/payer requirements.
Actively participate in case conferences, interdisciplinary team meetings, and quality improvement initiatives.
Must be a licensed RN
Must have Home Health experience
Must have OASIS experience with HCHB experience preferable
Main point of contact for field clinicians
Does have a team of clinicians reporting directly to them
Graduate from an approved school of professional nursing and currently licensed to practice as a registered nurse in the state of agency operation.
One (1) year experience as a RN.
Health Care Plan (Medical, Dental & Vision)
Retirement Plan (401k, IRA)
Life Insurance (Basic, Voluntary & AD&D)
Paid Time Off (Vacation, Sick & Public Holidays)
Family Leave (Maternity, Paternity)
Short Term & Long Term Disability
Training & Development