RN Case Manager

Essential Functions:

• Performs documentation/chart review to ensure accuracy and that the client’s POC is being followed. Performs submission of clinical documentation (weekly billing and payroll information) within specified deadlines.
• Maintains accurate information in Quick Base for all assigned clients. Inputs updated information on all assigned clients within a timely manner.
• Manages care implementation with attention to quality patient care and patient family satisfaction.
• Coordinates care authorization with Authorization Specialist(s) to establish the foundation for the development of the client’s treatment plan of care, including new admissions and re-certifications for current clients whom are on-service.
• Provides implementation, evaluation, and oversight of individual patient P.O.C. that corresponds with the physician’s orders through assessment of patient’s needs, condition, environment, and consultation with other health team members.
• Provides education to client regarding benefits, utilizing appropriate team members within the company structure and/or outside agencies to accomplish desired objective. (ie…DME, additional dx, home modifications, medication prior authorizations, etc.)
• Maintains an ongoing responsibility for assigned caseload.
• Attends all pertinent MD appointments with the client (including recertifications, specialists, impairments) as needed, or coordinates coverage within the team if unable to fulfil obligation.
• Builds rapport with patient families in implementing and managing care being rendered.
• Assists staffing department with scheduling work load as needed for maximum efficiency and remains detail oriented to deadlines.
• Maintains open communication with DON, ADON(s), other Case Managers, RN Authorization Specialist(s), non-licensed staff, support staff, and ancillary services. Notifies Scheduling Dept. and ADON(s) of any field related issues involving clients or employees.
• Communicates pertinent information (deaths, hospitalizations, changes in condition, etc…) via email with DON, ADON(s), Operations, Authorizations, Billing.
• Provides clinical guidance and coaching as needed for staff and patient families. Holds field staff accountable for level of care provided.
• Attends monthly Case Management meetings.
• Participates in staff in-service programs/continuing education in-services as scheduled.
• Participates in company designated committees per corporate direction.
• Participates in client home visits in service area per P&P and as needed.
• Abides by and promotes all Agency Policies &Procedures.
• Supports and takes initiative on necessary state and federal program regulations by process development, implementation, and evaluation of compliance for said regulations.
• Maintains a continuing knowledge of competencies related to the Nursing profession and adheres to accepted professional nursing standards/scope of practice.
• Participates in Case Management teams and attends to corresponding responsibilities per company development and growth. Maintains open communication with team CM regarding clients to ensure continuity of care.
• Treats current and perspective company clients and families with absolute customer service and compassion with close communication, friendly service, and the utmost professionalism.
• Available during company office hours to enable accessibility of service for potential and current patients and families as well as staff and colleagues. Notifies direct supervisor of any and all unavailability.
• Participates in performance review and goal setting for growth and company development in assigned territory.
• Ensures that arrangements for equipment and other necessary items and services are available; advocates for DME supplies and coordinates with DME representative.
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