Nurse Case Manager
Medicare RN case manager to work with in home care company
The Nurse Case Manager provides case management, coordination, supervision and implementation of professional and supportive services to patients/clients using nursing theory and process in accordance with the Nurse Practice Act.
Qualifications / Requirements / Expectations
Reviews client referral information and responds to requests and inquiries as appropriate.
• Evaluates eligibility and appropriateness of resident for home care services.
• Determines appropriateness of referral for home care services and responds per agency policy and standard guidelines.
Performs client assessments based on agency standards of practice to ensure effective and appropriate home care services.
• Applies standard nursing principles and practices to utilize a holistic approach to client care.
• Considers the physical, psychological, and socioeconomic needs of the client, the level of family acceptance, and the ability for client needs to be met in the home.
• Collaborates with physicians, other health care professionals (therapists, social services, pastoral care, supportive services), clients, and families in developing a comprehensive quality plan.
Directs, plans and initiates appropriate action independently and responsively in home care situations.
• Observes for and identifies overt and subtle signs of impending physiologic and psychological changes. Notifies the physician in accordance with agency policies and procedures.
• Makes decisions and/or recommendations that reflect consideration of immediate and long-range effects (frequency of visits, components of care plan, additional services).
• Confers with the clinical supervisor on a regular basis. Utilizes agency and community resources appropriately.
• Monitors documentation of clinical records to ensure compliance with regulatory standards of timeliness, accuracy, and completeness.
• Provides on-call support for clients per schedule.
• Communicates with other disciplines/departments when required.
1. Graduate of an accredited school of professional nursing program with a current license as a Registered Nurse in the state of employment.
2. Current license as a RN in the state(s) of practice; Baccalaureate degree preferred.
3. Minimum of two (2) years of nursing experience, with a combination of long-term care dementia care or acute care. Home care experience preferred.
4. Previous experience with MediCare
5. CRP certified.
6. Effective written and oral communication skills and good interpersonal skills.
7. Organizational, prioritization and time management skills.
8. Knowledge of Home Health regulatory and reimbursement requirements.
9. Twenty-one (21) years of age, meet the MVR organization standards, and have a valid driver’s license in the state the facility is located in.
10. Customer service oriented.
11. Possess adequate strength, coordination, dexterity and endurance to meet the strenuous physical demands of such resident care responsibilities as lifting and moving patients.
12. Must be a team player.
13. Ability to utilize computers and other electronic devices for tasks such as timekeeping, in-servicing and documentation.