RN Case Manager Home Health- Fulltime Days- ( In Field)

About the role

Full-time, 40 hours per week. Home Health Clinical RN/Case Manager for post-acute care patients following Wellstar care in hospitals, health parks, etc. Primarily 8:30 AM–5:00 PM, five days per week. Territory may extend to Wellstar locations surrounding Kennestone/Cobb.

Responsibilities

• Provide and supervise primary care to approximately 25–35 patients in their homes, including age-appropriate interventions that meet physical, emotional, developmental, psychosocial, and educational needs.
• Coordinate all disciplines throughout the episode of care and communicate with RNs, LPNs, therapists, social workers, home health aides, physicians, patients, families, and internal/external stakeholders.
• Develop and implement patient plans of care in accordance with physician orders and the nursing process.
• Manage patients from admission through recertifications to discharge, scheduling visits per physician orders and adjusting frequency based on clinical status.
• Perform routine and complex nursing procedures to meet patient needs.
• Revise plans of care based on patient needs within physician orders, coordinating with other disciplines to ensure goals are met and positive outcomes are achieved prior to discharge.
• Supervise LPNs and home health aides throughout the continuum of care; review and support their care plans.
• Maintain communication with physicians, reporting changes that may affect patient recovery.
• Provide patient/caregiver education to develop and encourage self-care and independence during recovery.
• Communicate patient status changes and lab results to physicians as appropriate; participate in care team conferences.
• Demonstrate knowledge and application of CMS, state, and Joint Commission regulatory guidelines; complete OASIS and visit documentation accurately and within established timeframes.
• Participate in orientation and education of new employees; attend continuing education and in-services as directed.
• Support and participate in performance improvement activities, including chart reviews and committees.
• Meet established productivity standards; participate in weekend and call rotation as required.

Requirements

• Minimum one year of medical/surgical nursing experience; ICU experience preferred.
• Knowledge of post-acute care in home/patient setting.
• Strong commitment to care, compassion, empathy, and patient/family communication.

Qualifications

• Associate Nursing or Diploma (Nurse) required; Bachelor’s in Nursing preferred.
• Current RN license in Georgia (or multi-state compact) and BLS certification required.
• Georgia driver’s license and private vehicle insurance required.

Skills

• Strong critical care assessment and clinical skills.
• Positive leadership, problem-solving, organizational, and time management skills.
• Excellent written and verbal communication skills.
• Ability to write and follow directions to patient homes; proficiency with Windows-based computers, home health software, email, internet, and computer-based learning modules.
• Understanding of home health operations, reimbursement, laws, and regulatory processes; OASIS knowledge preferred.