Registered Nurse Case Manager

The RN case manager is responsible for ensuring quality patient care via development, implementation, and evaluation, of individual patient care plans with-in the home setting. The Case Manager serves as the liaison between the Agency and patient families. They are responsible for day-to-day management, coordination, and supervision of the related clinical activities within their assigned service area utilizing professional standards of care and Agency Policy & Procedures.

The RN Case Manager reports directly to the Assistant Director(s) of Nursing in their assigned area and to the Director of Nursing utilizing the chain-of-command. Case Managers are expected to create and support positive environments through a personal commitment to the Company’s growth, vision and values.

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…