RN Case Manager- Home Health

Carilion Clinic•Tazewell, VA

8d•$34 - $50•Onsite

About The Position

The RN Case Manager, Home Health manages nursing care and provides individualized care for patients of all ages. The role uses delegation, critical thinking, and a collaborative, team-oriented approach to deliver quality patient care. The case manager assesses, plans, implements, and evaluates care to support optimum patient outcomes, completing and documenting age-specific admission and ongoing assessments and using them to develop the plan of care. This is a part-time position scheduled three days per week, including a Saturday, covering the Greater Tazewell region. Company equipment and mileage reimbursement are provided. Rotated on-call hours are required for evenings and weekends. The position also coordinates hospice patient and family care with the hospice interdisciplinary team, Medical Director, and attending physician, and participates in hospice events as assigned.

Requirements

Graduate of an accredited Registered Nurse program.
Currently licensed as a Registered Nurse in Virginia or an approved compact state.
Valid driver’s license, automobile insurance, and personal vehicle for making home visits.
Keyboarding skills for automated computer systems, including electronic medical records.
Knowledge of life span growth and development principles and ability to assess information reflecting patient status.
Ability to identify age-specific patient requirements and provide care according to departmental policies and procedures.
Advanced patient care knowledge and skills.
Strong critical-thinking skills, including the ability to interpret laws and regulations related to CHCS and Carilion Clinic.
Prioritization skills for work in a fast-paced patient care environment.

Responsibilities

Assume primary accountability for managing nursing care and providing individualized care for patients of all ages.
Assess, plan, implement, and evaluate patient care to achieve optimum outcomes.
Complete and document age-specific admission and ongoing assessments to support the plan of care.
Collaborate with the health care team, patients, and families to develop, implement, and revise interdisciplinary plans of care.
Administer and document treatments and medications using electronic medical record systems.
Ensure patient care orders are current, accurate, implemented, and evaluated for effectiveness.
Identify, implement, and document patient and caregiver education needs.
Promote patient safety, patient-centered care, and positive outcomes during transitions of care.
Serve as a patient advocate and support patients’ psychological, social, and cultural needs.
Apply knowledge of growth and development to care for assigned patients.
Use clinical expertise in rapidly changing circumstances.
Plan strategies to prevent avoidable rehospitalizations, reduce resource use, and improve patient outcomes.
Manage resources, establish priorities, and seek supervisory direction as needed.
Use problem-solving skills to resolve patient care and staff issues.
Participate in performance improvement activities and assigned projects.
Assist with new employee orientation and serve as a clinical role model.
Manage assigned patient care, including case conferences and care coordination.
Supervise LPNs and Home Health Aides as required by regulatory guidelines.
Maintain accurate and current case management documentation.
Ensure visit frequencies reflect provider orders and evidence-based practice.
Collaborate with scheduling, billing, and other departments to support care coordination, authorization, and communication of patient financial obligations.
Perform skilled visits, including OASIS and recertification visits, as needed.
Coordinate required forms, including BIPA, ABN, HHABN, or other forms required by CMS or agency policy.
Securely use electronic devices to access, transfer, and synchronize information to support communication and continuity of care.
Coordinate hospice patient and family care with the hospice interdisciplinary team, Medical Director, and attending physician.
Apply understanding of hospice care concepts and issues related to caring for terminally ill patients.
Provide competent, compassionate care in a variety of settings and comply with hospice policies and procedures.
Participate in special hospice events, such as grief camps and memorial services.
Work rotated on-call hours during evenings and weekends.