RN (Registered Nurse) Case Manager

About the role

Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.

Responsibilities

• 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
• Oversees and supervises total care of patient provided by nurse aides and LPNs
• 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