Registered Nurse Care Manager

Major Areas Of Responsibility

• Plan of Care (POC) review and revision to reflect accuracy and regulatory standards
• Recertification/Discharge review and recommendation
• Utilization/Calendar Management
• Adhere to Utilization Management Guidelines
• Participate in Interdisciplinary Team Meetings and Agency Townhall Meetings
• Seek opportunities to contain cost
• Review Charts to monitor compliance with regulatory and governmental regulations
• Maintains productivity standards and workflow expectations
• Functions as a resource for clinicians, agency staff, and internal staff
• Collaborates with clinicians as necessary for documentation clarification or educational opportunities
• Attends in-service trainings and mandatory agency meetings
• Stays current with CMS guidelines and Oasis Guidelines
• Reads and adheres to all Agency Policies and Procedures and follows Employee Handbook Guidelines
• Completes and submits all required documentation within specified company requirements

Qualifications

• Registered Nurse licensure required
• Two years home care field experience preferred
• One-year clinical review preferred
• Two years case management and/or utilization management experience preferred
• Demonstrates exceptional collaboration skills
• Self-starter and innovative problem solver
• Proficiency in HCHB preferred
• Knowledge of Medicare, Medicaid and all State/Federal guidelines for compliance of patient clinical care
• Strong clinical acumen to thoroughly understand the patient’s health and functional status and foster effective communication
• Able to create positive impressions and communicate effectively with a variety of people and personalities
• Is an active listener and demonstrates ability to engage care team in the patient plan of care
• Must project a professional image during virtual communication
• Observant and detail oriented
• Proficient in Microsoft Office including Excel, Outlook, Power Point and Word

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without reasonable accommodations.