Registered Nurse Case Manager (RN)

Summary

The Registered Nurse Case Manager (RNCM) assumes ultimate accountability and leadership for the assessment of the patient condition and plan of care. The RNCM provides case management, clinical care and is responsible for coordination all disciplines involved in providing quality, cost-effective and billable care through direct care and supervision of care under the direction of the physician. The RN educates patients and their family members and ensures the safety of the patient. The RN is accountable for completing accurate documentation and remains compliant with all legal rules and regulations. The RN is responsible for all practices and duties within the scope of practice as outlined by the state.

Qualifications & Attributes

• Registered Nurse with current license in the state of employment.
• Minimum of one year of experience as an RN in an acute care setting.
• Home care experience is desired.
• Ability to effectively communicate and create positive impressions with patients, families, physicians and co-workers.
• Ability to remain calm, have patience and be accommodating.
• Caring and compassionate while working with patients.
• Knowledgeable on nursing best practices.
• Ability to make appropriate nursing judgments.
• Ability to identify a situation and handle it with the best possible solution.
• Detail-oriented and observant.
• Disciplined style of work ethic with the ability to prioritize and be timely.
• Ability to follow directions and work as a team member.
• Valid driver’s license and auto insurance with your name as a listed driver.

Major Areas Of Responsibility

• Oversees the overall care of the patient from beginning to end of episode.
• Updates all doctor orders in patient chart accordingly.
• Notifies doctor of any significant changes of the patient’s condition.
• Manages multi-disciplinary care as applicable.
• Provides skilled nursing care in a patient’s home as ordered by the attending physician.
• Observes and monitors patient conditions.
• Performs OASIS assessments to develop an individualized plan of care and makes adjustments as needs change.
• Administers medication as prescribed by the physician.
• Helps decrease re-hospitalizations by front loading visits for high risk patients.
• Promotes continuity of care with appropriate admissions, transfers and discharges.
• Counsels patient and family on the disease/injury processes and how to manage.
• Incorporates patient and family in development of plan of care.
• Helps decrease re-hospitalizations by teaching the patient on preventative measures and making good decisions.
• Listens to patient and family members.
• Evaluates the treatments and medical condition of the patient according to the plan of care.
• Determines if the level of care being provided meets the patients’ needs.
• Communicates with the LPNs and nurse aides on supervisory visit results.
• Completes all clinical documentation in accordance with agency protocol and Medicare/Federal guidelines.
• Documents all aspects of treatment, assessments, and patient education.
• Maintains active RN license.
• Communicates with scheduler any changes outside the normal.
• Attends in-service trainings and mandatory agency meetings.
• Drives to patient’s primary location per scheduled visit.
• Daily attendance at assigned visit locations.
• Documents all aspects of subsequent, discharge, eval/recert/resumption of care visits within 24 hours of visits.
• Documents all aspects of start of care visits within 48 hours of visits.
• Completes and submits all required documentation within specified company requirements.
• Fulfills RN visits in assigned geographic location per patient need within federal and state specifications.

Health Qualifications

• Must be able to meet all physical position requirements.
• Must have evidence of a current negative tuberculin skin test or x-ray or receive TB testing at the date of orientation.
• An annual tuberculin skin test is required, unless the employee has documentation of a previous TB test.
• Employee must be free of physical/medical conditions, which would limit or restrict their ability to perform the job functions listed below.

Physical Demands

• Constantly (66%-100%): Reading, Speaking, Writing English Communications Skills Computer/PDA Usage Hand/finger dexterity Hearing/Seeing Talking in person Hearing in person Vision for close work
• Frequently (34%-66%): Walking Sitting Driving Talking on the phone Hearing on the phone
• Occasionally (2%-33%): Bending Standing Lifting up to 50 lbs. with or without assistance Stretching/Reaching Climbing Stooping (bend at waist)
• Rarely (1% or less): N/A

TRANSITIONAL WORK IS AVAILABLE

• ANSWERING PHONES
• FILING
• COMPUTER WORK/DATA ENTRY
• ATTENDING TRAINING/CONTINUING EDUCATION
• REVIEWING SAFETY MANUALS & OTHER EDUCATIONAL MEDIA
• ASSISTING OR PERFORMING OTHER TASKS WITHIN RESTRICTIONS ASSIGNED.