RN (Registered Nurse) Case Manager

Mercy Medical Center Home Health•Cleveland, OH

6d•Onsite

About The Position

The Registered Nurse Case Manager (RNCM) is accountable for assessing patient conditions and leading the development and coordination of plans of care. The role provides case management and skilled nursing care in patients’ homes, coordinating the care team and supervising care delivered by nurse aides and LPNs under physician direction. The RN educates patients and families, supports patient safety and continuity of care, and completes accurate, timely documentation in accordance with agency protocols and applicable legal, state, Medicare, and federal requirements. The position covers assigned geographic areas and includes scheduled visits, on-call duties, case conferences, trainings, and agency meetings.

Requirements

At least one year of RN experience 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 to patients.
Knowledge of nursing best practices and ability to make appropriate nursing judgments.
Ability to identify situations and determine appropriate solutions.
Detail-oriented and observant.
Disciplined work ethic and 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 throughout the episode and coordinate multidisciplinary care as applicable.
Update physician orders in the patient chart and notify the physician of significant changes in the patient’s condition.
Provide skilled nursing care in patients’ homes as ordered by the attending physician; observe and monitor patient conditions and administer prescribed medication.
Complete OASIS assessments, develop individualized plans of care, and adjust them as patient needs change.
Promote continuity of care through appropriate admissions, transfers, and discharges.
Help prevent rehospitalizations by front-loading visits for high-risk patients and teaching patients preventive measures and sound decision-making.
Counsel patients and families about disease or injury processes and care management; listen to them and involve them in developing the plan of care.
Oversee and supervise patient care provided by nurse aides and LPNs; evaluate treatments and patient condition against 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 according to agency protocol and Medicare and federal guidelines, documenting treatments, assessments, and patient education.
Document start-of-care and subsequent, discharge, evaluation/recertification, and resumption-of-care visits within 24 hours; submit all required documentation within company deadlines.
Maintain an active RN license and follow the plan of care within the RN scope of practice.
Communicate schedule 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 patient locations and complete visits in the assigned geographic area according to patient needs and applicable federal and state specifications.
Perform other duties as assigned.