RN Case Manager - Home Health, Full-time

Dartmouth-Hitchcock Health•Hartford, VT

1d•Onsite

About The Position

The RN Case Manager provides home health care to patients referred by a licensed provider, working under the direction of the Clinical Manager. The role involves assessing and treating patients, coordinating care with the patient and the interdisciplinary health care team, and supporting high-quality care in patients’ homes. The position serves the Upper Valley and surrounding area, as part of Dartmouth Health Home Care, which provides nursing, rehabilitation, hospice, and personal care services across more than 70 towns. The role is offered full-time and part-time, with day shifts from 8:00 a.m. to 4:30 p.m. and an on-call requirement. The RN Case Manager develops and reviews patient care plans with physicians, patients, families, and primary caregivers; monitors clinical, functional, and emotional status; documents assessments and goals; provides patient and caregiver education; and provides clinical oversight of LPNs and LNAs. A $10,000 new-hire retention bonus is available, subject to conditions.

Requirements

Be a graduate of an accredited school of nursing.
Hold at least one active, unencumbered RN license in Vermont or New Hampshire at the time of hire.
Have active, unencumbered RN licenses in both Vermont and New Hampshire within 30 days of the hire date.
Hold a valid driver's license with a clean driving record.
Have current car insurance that meets minimum standards.
Obtain BLS within 90 days of hire.

Nice To Haves

One year of experience as an RN in a home health care setting is preferred.

Responsibilities

Screen, evaluate, re-evaluate, and treat patients referred by a licensed provider.
Coordinate and communicate treatment activities with health care team members and patients.
Work with the interdisciplinary team to ensure high-quality patient care.
Develop a care plan at admission with the patient's physician, the patient, and their family or primary caregivers.
Periodically review and recertify patient care plans as appropriate.
Coordinate care plans through interdisciplinary communication and case conferences, as appropriate.
Advise other disciplines of discharges in a timely manner.
Continuously assess patients’ clinical, functional, and emotional status to identify problems and progress toward goals.
Communicate significant changes in patient status to the physician and Dartmouth Health Home Care colleagues.
Document evaluations, treatment goals, and objectives.
Teach patients and caregivers self-care techniques as appropriate.
Provide medication, diet, and other instructions as ordered by the provider, and offer health counseling to patients and caregivers.
Provide clinical oversight of LPNs and LNAs in the home.
Perform other related duties as assigned to meet organizational needs.