This role assumes responsibility for caseloads consisting of patients in specialty areas. The Registered Nurse Case Manager will conduct initial assessments to obtain thorough physical, social, and environmental data. They will establish the plan of care in accordance with physician orders and patient needs, provide direct patient care, and adjust nursing care processes as needed. This includes identifying problems, modifying the nursing care plan, and evaluating outcomes. The nurse will advise and consult with family and other personnel as appropriate, and provide ongoing assessment of patient response to treatments and teaching, applying interventions as appropriate. Updating and revising the plan of care as indicated is also a key responsibility. The role requires prompt and accurate completion of documentation, including visit assessments, OASIS, 485, and verbal orders, within agency standards. Communication with physicians is crucial to confirm and update patients' plan of care, providing status updates and ensuring ongoing communication with the physician and other members of the health care team. Facilitating the discharge planning process according to standards and utilizing resources to assure continuity of care after discharge is essential. The nurse will participate in developing the discharge plan with the patient/family, physician, social worker, and other staff members as appropriate. Additionally, participation in chart audits and continuous quality improvement activities is expected, along with identifying, developing, and participating in process improvement opportunities to enhance service quality. Maintaining and updating accurate clinical and patient records according to agency, state, and federal guidelines is required. The incumbent must demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served, understanding the principles of growth and development over the life span and possessing the ability to assess and interpret data reflective of patient status and their age-specific needs.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree