RN Case Manager

Valence Care - HCS - Girling NY - Extended Home Care - A&J Staffing - A Better Life - Direct Care

9d•$110,000 - $120,000•Onsite

About The Position

Preferred Certified Home Care is looking for an experienced and qualified RN Case Manager to manage and oversee the homecare services provided to our patients. This role is responsible for the case management of quality home care services rendered to patients. The RN Case Manager will apply age-specific criteria, assess and treat patients of all ages, and understand the cognitive, physical, emotional, and chronological processes for each age group. They will plan, implement, manage, and evaluate professional and ancillary home health services to meet patient needs and ensure quality care in accordance with Federal, State, and agency guidelines. This includes establishing and updating care plans, completing all required documentation (interdisciplinary referral form, 485, OASIS, interim physician orders, coordination notes), and managing the multidisciplinary team. The role involves reviewing reports, evaluating patient care needs, communicating with physicians, coordinating care with other providers, participating in meetings, and maintaining an assigned caseload. The RN Case Manager will also facilitate care in the home setting by utilizing community resources, counseling, teaching, and advocating for the patient. They will update the Home Health Aide plan of care, develop discharge plans, and ensure visits are authorized by managed care insurance companies. The position also includes monitoring the quality of therapeutic services, participating in performance improvement activities, case conferences, and the agency's Quality Assurance Performance Improvement Program. Collaboration with the Interdisciplinary Team is key to developing interventions for patient goals. Accurate and timely documentation in the patient's clinical record is essential, along with sound judgment regarding corporate compliance.

Requirements

Graduate of an accredited School of Nursing required.
Current Registered Nurse license with NYS Department of Education required.
Minimum of 1 year recent medical/surgical nursing experience required.

Nice To Haves

BSN preferred.
Experience in Long Term and/or Acute Care Facility preferred.
Experience with MRDD patient and/or Public/Community Health preferred.
Familiarity with EMR and computer applications (Word, Excel) preferred.
UAS certification also preferred.
Previous CHHA experience with OASIS documentation is strongly preferred.

Responsibilities

Competent to apply age specific criteria as appropriate. Responsible for the assessment and treatment for patients of all ages, including neonates, children, adolescents, adults and geriatric.
Understands the cognitive, physical, emotional and chronological processes for all ages. Treatment reflects an understanding for the developmental needs for each patient.
Plans, implements, manages and evaluates the provision of both professional and ancillary home health services to ensure that all patient’s needs are met and quality care is provided in accordance with Federal, State and agency guidelines.
Establishes and updates the care plan with written input from the patient/caregiver, physician and other multidisciplinary health team members.
Completes all required documentation according to agency policy and in a timely manner which include; interdisciplinary referral form, 485, OASIS, interim physician orders and coordination notes.
Familiarity with MLTCP and commercial payer requirements for care.
Manages the activity of the multidisciplinary team providing care to patients as well as ensure that all visits scheduled and provided are authorized and covered by a physician order.
Reviews reports, evaluates ongoing patient care needs and communicates those needs to the physician.
Contact/follow up with physicians and other patient care providers when necessary to assist with care coordination.
Participate in staff/team meetings as required.
Maintains an ongoing responsibility for assigned caseload.
Maintains proficiency in clinical and administrative skills.
Demonstrates sound judgment and independent problem solving skills in order to initiate appropriate intervention with regard to patient’s psychosocial and/or physical impairment.
Facilitates the care of the patient in the home setting by utilizing appropriate community resources, counseling and teaching patient and patient’s family and advocating on behalf of the patient.
Communicates case load and patient care issues to the Clinical Manager.
Updates the Home Health Aide plan of care, communicates with Home Health Aide Coordinator.
Develops, implements, and carries out a discharge plan in conjunction with the Primary field, patient/caregiver and members of the health care team. Interprets agency policy to patient and patient’s families.
Ensures that all visits made have prior authorization if required by the patient’s managed care insurance company. Works collaboratively with managed care insurance company.
Monitors the quality of therapeutic service through written and verbal communications with all disciplines. Participates in performance improvement activities, team meetings and orientation as requested.
Participates in case conferences and/or clinical rounds to provide guidance ton care, while reinforcing best practices.
Participates in the agency’s Quality Assurance Performance Improvement Program/PIP as designated or assigned.
Works with other members of the Interdisciplinary Team to develop appropriate interventions in order to achieve the clinical and functional goals of assigned patients.
Documents accurately, timely and completely in patient’s clinical record in accordance with CMS/DOH regulations.
Write an accurate and concise clinical/progress note that reflects implementation of the plan of care and the patient’s response to that plan of care.
Demonstrates sound judgment by taking appropriate actions regarding suspected violation of corporate compliance regulations.
Reports all suspected violations to supervisor, Compliance Officer or Compliance Hotline.
Performs other nursing activities as directed.