Home Health RN, Case Manager, Eligible for Sign on Bonus!

Tufts Medicine•Newburyport, MA

2d•Remote

About The Position

This role focuses on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following Home Care Nurse duties: Assesses, plans, implements, and evaluates the care needs of a designated group of patients or provides nursing care and identified clinical support tasks within the scope of practice for achievement of the patient’s plan of care as directed. Provides professional nursing care to patients. Requires a nursing license. A professional individual contributor role that may direct the work of other lower level professionals or manage processes and programs. The majority of time is spent overseeing the design, implementation or delivery of processes, programs and policies using specialized knowledge and skills typically acquired through advanced education. A senior level role that requires advanced knowledge of job area typically obtained through advanced education and work experience. Typically responsible for: managing projects / processes, working independently with limited supervision, coaching and reviewing the work of lower level professionals, resolving difficult and sometimes complex problems. Utilizing the nursing process, the Home Health Registered Nurse will manage and deliver comprehensive home health services, including assessments, interventions, and supportive care to clients within their place of residence. Depending on the circumstances, duties may also include telephone triage, problem solving, patient/caregiver advocacy and support, with emphasis of avoiding hospitalization. As a key member of the health care team, this position must interact courteously and effectively with patients and their families as well as with coworkers from all Agency departments, community resources, and with patients' physicians in order to facilitate safe and efficient patient care while maintaining their own safety in the home and the community at large.

Requirements

Massachusetts RN Licensure.
Valid state issued Driver’s License.
One (1) year of acute medical/surgical nursing experience.
Cardiopulmonary Resuscitation (CPR) Certification.

Responsibilities

Assesses patients' physical, psychosocial needs in a sensitive, caring manner following established Standards of Nursing Practice and VNA procedures.
Assesses patient/family learning needs, style and limitations and adjusts for delivery of information.
Establishes realistic goals and develops plans of treatment in cooperation with the patient, family and members of the health care team.
Adapts to new and unusual situations without affecting work performance negatively.
Utilizes Security when and if needed for any potential unsafe situations.
Collaborates with patient /family and other health care providers and/or community resources with planning of care and discharge.
Completes physicians' orders, levels of care, and OASIS on all patients assigned, in accordance with patient care policies.
Reconciles medications with patient and physician consistently.
Demonstrates ability to cope with patient/family emotional stress and provide appropriate supportive care.
Effectively manages assigned caseload, within the team model of care delivery.
Establishes a daily work plan based upon patient/family priorities of service and total area needs.
Promptly triages patient visits, messages, and phone calls according to priority and urgency.
Demonstrates excellent physical assessment and care planning skills.
Demonstrates current knowledge of pharmacology and medication administration and reconciliation.
Coordinates care and discharge planning with other team members during case conferences.
Acquires and maintains an expert working knowledge of all third part payers and regulatory bodies and agency policies on issues related to documentation and care provided.
Communicates and collaborates with all disciplines in the home care setting on a regular basis or immediately if there are any critical needs or crisis interventions needed.