As a Home Health RN Case Manager, you will provide admission, case management, and follow-up skilled nursing visits for home health patients. You will administer on-going care and case management for each patient, providing necessary follow-up as directed by the Clinical Manager. You will confer with the physician in developing the initial plan of treatment based on physician's orders and initial patient assessment. You will provide hands-on care, management, and evaluation of the care plan and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision. You will revise the plan in consultation with the physician based on ongoing assessments and as required by policy/regulation. You will coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Home Health Aides, and external providers). You will report patient care/condition/progress to the patient's physician and Clinical Manager on a continuous basis. You will implement the patient care plan in conjunction with the patient and family to assist them in achieving optimal resolution of needs/problems. You will coordinate/oversee/supervise the work of Home Health Aides, Certified Home Health Aides and Personal Care Workers and provides written personal care instructions/care plan that reflects the current plan of care. You will monitor the appropriate completion of documentation by home health aides/personal care workers as part of the supervisory/leadership responsibility. You will discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation. You will prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes. You will prepare visit/shift reports, updates/summarizes patient records and confers with other health care disciplines in providing optimum patient care.
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Job Type
Full-time
Career Level
Mid Level