Registered Nurse Case Manager - Home Health

Benefits:

• 401(k)
• Health insurance
• Paid time off
  
  
  

Job Summary:

The RN Case Manager in an office-based home health setting is responsible for managing the coordination and oversight of patient care in a non-clinical office environment. This includes creating, reviewing, and updating care plans, coordinating with field nurses and healthcare teams, and ensuring compliance with healthcare regulations. The RN Case Manager will also communicate with patients, families, and healthcare professionals to ensure care delivery is effective and aligns with patient needs.

Key Responsibilities:

• Care Coordination and Case Management:
• Coordinate care for home health patients by working closely with physicians, social workers, physical therapists, and home health aides.
• Ensure that care plans are developed based on accurate patient assessments and are in line with clinical guidelines and regulations.
• Monitor patient progress remotely by reviewing reports from field staff and communicating with patients as needed.
• Serve as the primary contact for patients, caregivers, and healthcare providers, ensuring all parties are informed of care plan updates.
• Patient Care Planning:
• Develop, implement, and adjust individualized care plans, ensuring they are comprehensive and meet the patient’s needs.
• Analyze patient information from the field team and adjust care strategies when necessary.
• Collaborate with the clinical team to ensure that all aspects of care, including medications, therapy, and equipment, are in place and properly managed.
• Interdisciplinary Team Collaboration:
• Facilitate regular meetings or communications with the home health team to discuss patient status, challenges, and adjustments to care plans.
• Guide the team on providing high-quality care to patients in their homes, including addressing any clinical or safety concerns.
• Review and resolve any issues or concerns raised by field staff regarding patient care.
• Documentation and Compliance:
• Ensure accurate documentation of all care plans, assessments, and patient interactions in the electronic health record (EHR) system.
• Review and audit documentation from field staff to ensure compliance with company policies, Medicare/Medicaid regulations, and other relevant standards.
• Monitor patient outcomes and maintain a thorough record of care plan updates and progress notes.
• Quality Improvement and Regulatory Compliance:
• Participate in quality improvement initiatives and support efforts to enhance patient outcomes.
• Ensure that all care provided is in accordance with home health care regulations, such as Medicare/Medicaid standards, and state/local guidelines.
• Assist in ensuring the agency meets accreditation and licensing requirements.
• Patient Advocacy:
• Serve as a resource for patients and families, providing education and answering questions about care plans, treatment options, and home health services.
• Advocate for the patient’s needs in discussions with the healthcare team to ensure personalized and effective care.
• Support for Field Staff:
• Provide guidance and support to field nurses, home health aides, and other team members, ensuring they have the resources and information needed to provide quality care.
• Serve as an escalation point for field staff in cases of clinical uncertainty or patient concerns.
  
  
  

Required Qualifications:

• Education:
• Registered Nurse (RN) with a current, active license in the state of employment.
• A Bachelor of Science in Nursing (BSN) is preferred but not always required.
• Experience:
• At least 2 years of clinical nursing experience, with prior experience in home health or case management preferred.
• Experience in patient assessment, care planning, and coordinating care among an interdisciplinary team.
• Skills:
• Excellent communication and interpersonal skills, as this position requires frequent interactions with patients, families, physicians, and team members.
• Strong organizational and time-management skills for managing multiple patients and coordinating care from an office environment.
• Proficiency in using Electronic Health Records (EHR) and other relevant software systems.
• Knowledge of home health care regulations, Medicare/Medicaid guidelines, and insurance billing.
  
  

Preferred Qualifications:

• Certification in Case Management (CCM), Home Health (CHPN), or a related specialty.
• Experience with office-based roles in home health agencies.
• Knowledge of regulatory requirements for home health care and patient privacy laws (HIPAA).
  
  
  

Physical Requirements:

• This role is primarily office-based but may require occasional visits to patient homes or external locations for meetings and evaluations.
• Ability to work at a desk and use a computer for extended periods.
  
  
  

Work Schedule:

• Typically Monday through Friday during business hours, with the possibility of on-call duties or evening hours based on the organization’s needs.
  
  
  

Compensation and Benefits:

• Benefits package, which includes health insurance, retirement plans, paid time off, and opportunities for professional development and continuing education.
  
  
  

This role requires a blend of clinical nursing knowledge and office-based management skills. The RN Case Manager must balance the demands of patient care with the ability to coordinate and oversee multiple facets of the healthcare team, all while ensuring compliance and high-quality care.