RN (Registered Nurse) Case Manager

Alternate Solutions Health Network•Detroit, MI

About The Position

The Registered Nurse Case Manager (RNCM) assumes ultimate accountability and leadership for assessing patients’ conditions and developing their plans of care. The RNCM provides case management and clinical care, and coordinates all disciplines involved in delivering quality, cost-effective, billable care through direct care and supervision under the direction of the physician. The RN educates patients and their family members, ensures patient safety, completes accurate documentation, and complies with applicable legal requirements and state scope-of-practice rules. This position is with Beaumont Home Health and serves Troy, Royal Oak, Madison Heights, Clawson, and Berkley. The regular schedule is Monday through Friday, 8 a.m. to 5 p.m., with on-call coverage for two weekend shifts and three weekday shifts per month, as well as one winter and one summer holiday on call. The RN drives to patients’ primary locations for scheduled visits and attends assigned visit locations daily.

Requirements

At least one year of experience as an RN in an acute care setting.
Current Registered Nurse license in the state of employment.
Valid driver’s license and auto insurance listing the employee as a driver.
Ability to communicate effectively and create positive impressions with patients, families, physicians, and coworkers.
Ability to remain calm, patient, and accommodating.
Compassionate and caring approach when working with patients.
Knowledge of nursing best practices and ability to make appropriate nursing judgments.
Ability to identify situations and handle them with the best possible solution.
Detail-oriented and observant.
Disciplined work ethic, with the ability to prioritize and be timely.
Ability to follow directions and work as a team member.

Nice To Haves

Home care experience.

Responsibilities

Oversee the patient’s care from the beginning to the end of the episode.
Update doctor orders in the patient chart and notify the doctor of significant changes in the patient’s condition.
Manage multidisciplinary care as applicable.
Provide skilled nursing care in patients’ homes as ordered by the attending physician.
Observe and monitor patient conditions.
Perform OASIS assessments to develop individualized plans of care and adjust plans as patient needs change.
Administer medications as prescribed by the physician.
Help decrease re-hospitalizations by front-loading visits for high-risk patients and teaching patients preventative measures and sound decision-making.
Promote continuity of care through appropriate admissions, transfers, and discharges.
Counsel patients and families about disease or injury processes and how to manage them.
Involve patients and families in developing plans of care and listen to their concerns.
Oversee and supervise the total care provided by nurse aides and LPNs.
Evaluate treatments and patients’ medical conditions according to the plan of care and determine whether the level of care meets patient needs.
Communicate supervisory visit results to LPNs and nurse aides.
Complete clinical documentation in accordance with agency protocols and Medicare and federal guidelines, documenting treatment, assessments, and patient education.
Complete documentation for subsequent, discharge, evaluation/recertification, and resumption-of-care visits within 24 hours; complete start-of-care documentation within 24 hours.
Submit all required documentation within company deadlines.
Follow the plan of care within the scope of practice for a Registered Nurse.
Fulfill RN visits in the assigned geographic area according to patient needs and federal and state specifications.
Maintain an active RN license.
Communicate schedule changes outside the normal schedule to the scheduler.
Participate in on-call requirements and case conferences.
Attend in-service training and mandatory agency meetings.
Drive to patients’ primary locations for scheduled visits and attend assigned visit locations daily.
Perform other duties as assigned.