RN Case Manager Homecare - Waukesha

Patient and Family Assessments

Assess patient’s and family’s physical, pain, psychosocial, emotional, spiritual, environmental and educational needs as outlined by the plan of care (POC).

Collect data from the patient, family, significant other or other members of the interdisciplinary team and other health care professionals.

Identify, interpret, and document assessment data collected in the nursing interview, physical assessment and other health data.

Document and report significant changes in condition or unusual incidents to appropriate IDT member such as client abuse/neglect, suicidal intent, harmful coping mechanisms or violence, etc.

Collaborate with IDT and primary care provider to create HES for determination of hospice eligibility.

Patient Visits

Respond to patient and family needs or change in condition or need for acute patient intervention.

Provide interventions, treatments, and pain management to patient and family to meet needs.

Evaluate the effectiveness of pain management or other intervention and adjust to meet needs.

Provide patient and family education on pain, symptom management, end of life, etc.

Evaluate the effectiveness of education and adjust to meet needs.

Plan of Care

Formulate, implement, and revise individualized POC in collaboration with Interdisciplinary Team (IDT), patient, and family.

The POC to include goals, pain management, interventions, education, discharge plan, etc.

Develop reasonable and achievable outcome measures and establish priorities in the planning and provision of care.

Read, understand, and follow the plan of care.

Document interventions, outcomes, and changes in patient condition in electronic health record (EHR).

Delegate visits to appropriate disciplines and manage visit sets.

Oversee work of Certified Nursing Assistants (CNA) and Licensed Practical Nurses (LPN).

You Bring

• ADN or BSN required
• Current, unrestricted Registered Nursing License in state of employment
• One-year nursing experience, preferred
• Valid driver’s license, auto insurance, and access to a reliable vehicle
• Must be at least 18 years of age
• Basic Microsoft Office Skills
• Intermediate electronic health records skills
• Ability to use proper body mechanics, safe patient handling, and standard precautions

About Agrace

For more than 45 years, Agrace has been an innovator and leader in both caring for patients and their families, and in educating others about death, dying and grief.

We are the largest hospice provider in Wisconsin.

Well known for end-of-life care, Agrace also serves people across southern Wisconsin who are aging, seriously ill or grieving.

At Agrace we are strengthened by the unique experiences, cultures and traditions of our staff, patients and clients.

Together, we pursue a vision in which every Agrace staff member is treated fairly, and every patient and client experiences the respectful, individualized care they need and deserve.

Agrace Health Inc. is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.