Case Managers

Under the leadership of the Director, Home Health, the Home Health Case Manager I is an active member of the Home Health team delivering professional end‑of‑life care and services consistent with the strategic vision of the Home Health Department and CRHS. The Home Health Case Manager reviews patient and family needs and develops age‑appropriate, culturally sensitive nursing care for patients of all ages in their homes.

The Home Health Case Manager formulates an appropriate nursing plan of care with goals set collaboratively with the RN and the patient and/or caregiver. The Case Manager also formulates an appropriate and safe aide plan of care and supervises the aide every 14 days in the patient’s home, assessing the effectiveness of interventions and education to the patient and his/her family.

• Assesses patient and develops plan of care, establishes mutually agreed upon goals with the patient, caregivers, and/or family members.
• Develops an appropriate and safe aide plan of care based on the patient’s medical, psychosocial, and emotional needs and environmental and financial factors that affect the current and future patient status.
• Supervises the care rendered by the CNA and LPN within the patient’s home and ensures compliance with the established plan of care.
• Renders professional nursing care, including the administration of medicine and drugs, monitoring IV's, performing venipuncture, inserting intravenous catheters, performing the more complex as well as routine treatments as prescribed by the physician or as indicated by the resident’s condition.
• Obtains referrals for other skilled services as indicated.
• Provides emotional support and education to patients and their families.
• Ensures the compliance with established infection control procedures by all caregivers and/or family members.
• Ensures the accurate documentation of assessments, care plans, goals, medications, communications, and interventions.
• Reviews and revises the plan of care every 60 days and as needed.
• Reports significant changes in the patient’s condition promptly to the attending physician.
• Utilizes nursing skills to independently administer intermittent safe, timely and effective nursing care and therapeutic treatment in the patient’s home as ordered by the physician.
• Evaluates and documents the effectiveness of the plan of care as developed by all members of the interdisciplinary team working with the patient.
• Actively participates in Home Health interdisciplinary group meetings and home health care conferences.
• Submits completed documentation in accordance with established standards for timeliness and accuracy.
• Complies with Home Health quality, satisfaction, and regulatory compliance standards to ensure they are either met or exceeded.
• Works continually to identify new approaches that improve the quality and timeliness of Home Health care.
• Follows all Hospice policies and procedures and ensures compliance with all federal and state laws, regulations, and JCAHO requirements.
• Completes all required professional education including continuing nursing education hours and mandatory in‑services to maintain professional licensure.
• Performs other related job duties as assigned.

• Associate’s degree in nursing.
• One to two years of work‑related experience or equivalent combination of education, training, and experience.
• Current state license as a Registered Nurse.
• Current Basic Life Support (BLS) certification (must be obtained within three months of hire if not current).
• Current valid Driver’s License and minimum automobile insurance. Requires a current valid driver’s license. A Motor Vehicle Report is required upon hire and reviewed annually.

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