RN (Registered Nurse) Case Manager

Mercy Medical Center Home Health•Cleveland, OH

About The Position

The Registered Nurse Case Manager (RNCM) provides leadership and accountability for assessing patient conditions and developing and overseeing plans of care. The RNCM provides case management and skilled nursing care, coordinates the disciplines involved in delivering quality, cost-effective, billable care, and supervises care under the direction of the physician. The role includes educating patients and families, promoting patient safety, documenting care accurately, and complying with applicable legal requirements and the state-defined scope of practice. This position is with Southwest General Home Health Care and covers Marcedonia, Northfield, Twinsburg, Garfield Heights, North Randall, Maple Heights, Solon, Oakwood Village/Bedford, Parma, Broadview Heights, North Royalton, and Hinkley. The schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m., with on-call requirements of one Saturday or Sunday per month, three weeknights per month, one working holiday per year, and one on-call holiday per year. The RN drives to patients’ primary locations 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.
Compassion and care when working with patients.
Knowledge of nursing best practices.
Ability to make appropriate nursing judgments, identify situations, and handle them with an appropriate 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 physician orders in the patient chart and notify the physician 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, develop individualized plans of care, and adjust them as patients’ needs change.
Administer medications as prescribed by the physician.
Help reduce rehospitalizations by front-loading visits for high-risk patients and teaching patients preventive measures and sound health decisions.
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 patient treatments and 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/Federal guidelines, including documentation of treatment, assessments, and patient education.
Document subsequent, discharge, evaluation/recertification, resumption-of-care, and start-of-care visits within 24 hours, and submit required documentation within company deadlines.
Maintain an active RN license and follow the plan of care within the Registered Nurse scope of practice.
Communicate changes outside the normal schedule to the scheduler.
Participate in on-call requirements and case conferences.
Attend in-service trainings and mandatory agency meetings.
Drive to patients’ primary locations for scheduled visits and fulfill RN visits in the assigned geographic area according to patient needs and federal and state specifications.
Perform other duties as assigned.