About the Client:
The client is a leading provider of home health services, dedicated to delivering compassionate, patient-centered care to families and individuals in the comfort of their homes. Their mission is to enhance the quality of life for patients through exceptional clinical care, innovative practices, and a commitment to empathy and excellence. They believe in fostering a supportive and collaborative work environment where every team member can thrive and contribute to the shared goal of providing the highest standard of care.
Position Overview:
The RN Case Manager is responsible for overseeing the comprehensive care and coordination of services for patients within their caseload. This role requires a nurse with excellent organizational skills, strong communication abilities, and a dedication to providing high-quality patient care. The RN Case Manager will work closely with patients, families, Primary Care Physicians (PCPs), therapy providers, and internal support teams to ensure optimal patient outcomes.
Reports To: Clinical Lead
Key Responsibilities
Patient Care and Coordination:
- Manage a diverse caseload, ensuring quality patient care and efficient care coordination.
- Provide coaching, oversight, and support to Certified Nursing Assistants (CNAs) to ensure high-quality patient care and adherence to clinical standards.
- Develop and implement individualized care plans based on patient assessments and goals.
- Coordinate with PCPs, therapy providers, and internal support teams to ensure comprehensive care.
- Provide education and support to patients and families regarding their health care needs and treatment plans.
Clinical Documentation:
- Maintain accurate and timely electronic charting, with a preference for real-time documentation.
- Ensure all documentation meets regulatory and client standards, with a minimum of 24-hour turnaround time.
Communication and Collaboration:
- Establish and maintain effective communication with PCPs, therapy providers, and internal support teams.
- Escalate appropriate issues to Clinical Leads in a timely manner, such as order management and patient concerns.
- Participate in on-call rotation (approximately one weekend per month), holiday rotation, and possible phone triage night coverage during weekdays.
Quality Assurance:
- Achieve caregiver satisfaction by providing high-quality, compassionate care and support.
- Monitor and work to improve patient readmission rates.
- Ensure extended visits remain within acceptable ranges and administrative tasks (e.g., mileage reimbursements) are completed thoroughly.
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