The PM Home Health Registered Nurse Case Manager will assume responsibility for caseloads consisting of patients in specialty areas. This role involves conducting initial assessments to obtain thorough physical, social, and environmental data, and establishing a plan of care in accordance with physician orders and patient needs. The nurse will provide direct patient care, adjust nursing care processes as needed, identify problems, modify nursing care plans, and evaluate outcomes. Additionally, the role includes advising and consulting with family and other personnel, providing ongoing assessment of patient response to treatments and teaching, and updating the plan of care as indicated. The position requires prompt and accurate completion of documentation, including visit assessments, OASIS, 485, and verbal orders, adhering to agency, state, and federal guidelines. Communication with physicians to confirm and update patient plans of care, providing status updates, and ensuring ongoing communication with the healthcare team are crucial. The nurse will also facilitate the discharge planning process and participate in chart audits and continuous quality improvement activities. A key aspect of the role is identifying and participating in process improvement opportunities to enhance service quality. The nurse must demonstrate knowledge and skills appropriate for the age of the patients served, understanding principles of growth and development and assessing data reflective of patient status to meet age-specific needs.
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Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree