Registered Nurse (RN) Case Manager

Alternate Solutions Health Network•Detroit, MI

7d•Onsite

About The Position

The Registered Nurse Case Manager (RNCM) assumes leadership and accountability for assessing patient conditions and developing plans of care. The RN provides case management and clinical care, coordinating the disciplines involved in delivering quality, cost-effective, billable care through direct care and supervision under physician direction. The RN educates patients and family members, promotes patient safety, completes accurate documentation, and complies with applicable legal requirements and state scope-of-practice rules. This role provides skilled nursing services in patients’ homes across Warren, Hazel Park, Pleasant Ridge, Ferndale, Detroit, Highland Park, and Hamtramck. The schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m., with on-call responsibilities for three weekdays and two weekend days per month. The RN drives to scheduled patient visits and participates in case conferences, in-service training, and mandatory agency meetings.

Requirements

At least one year of experience as an RN in an acute care setting.
Current Registered Nurse license in the state of employment.
Valid driver’s license and auto insurance listing the employee as a driver.
Ability to communicate effectively and create positive impressions with patients, families, physicians, and coworkers.
Ability to remain calm, patient, accommodating, compassionate, and caring when working with patients.
Knowledge of nursing best practices and ability to make appropriate nursing judgments.
Ability to identify situations and handle them with an appropriate solution.
Detail-oriented and observant work style.
Disciplined work ethic, with the ability to prioritize and be timely.
Ability to follow directions and work as a team member.

Nice To Haves

Home care experience is desired.

Responsibilities

Oversee the patient’s overall care throughout the episode.
Update physician orders in the patient chart and notify the physician of significant changes in the patient’s condition.
Manage multidisciplinary care as applicable and coordinate care among involved disciplines.
Provide skilled nursing care in patients’ homes as ordered by the attending physician; observe and monitor patient conditions and administer prescribed medications.
Perform OASIS assessments to develop individualized plans of care and adjust them as patient needs change.
Help reduce rehospitalizations by front-loading visits for high-risk patients and teaching patients preventative measures and sound decision-making.
Promote continuity of care through appropriate admissions, transfers, and discharges.
Counsel patients and families about disease or injury processes and how to manage them; involve them in developing the plan of care and listen to their concerns.
Oversee and supervise care provided by nurse aides and LPNs, evaluate treatments and the patient’s condition against the plan of care, determine whether the level of care meets patient needs, and communicate supervisory visit results to LPNs and nurse aides.
Complete clinical documentation in accordance with agency protocol and Medicare and federal guidelines, including documentation of treatment, assessments, and patient education.
Document subsequent, discharge, evaluation/recertification, resumption-of-care, and start-of-care visits within 24 hours of the visit, and submit required documentation within company deadlines.
Maintain an active RN license and follow the plan of care within the scope of RN practice.
Communicate schedule changes outside the normal schedule to the scheduler.
Participate in on-call requirements and case conferences; attend in-service trainings and mandatory agency meetings.
Drive to patients’ primary locations and attend assigned visit locations daily; fulfill RN visits in the assigned geographic area according to patient needs and federal and state specifications.
Perform other duties as assigned.