Job Title: RN Case Manager
Profession: Nursing
Specialty: Home Health
Duration: 13 weeks
Shift: Day
Hours per Shift: 8
Experience: Previous clinical experience in an acute care setting or home health setting assessing skilled care needs and equipment and health maintenance resource needs.
License: Active RN License
Certifications: CRASE training
Must-Have: Graduate of an accredited school of nursing
Description:
Assesses, develops, implements, and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the patient and family.
Comprehensively assesses patients' goals as well as their biophysical, psychosocial, environmental, functional, and financial status.
Procures services and serves as an advocate on behalf of patients and families for scarce resources.
Directs families to arrange for services that require patient/family decision and participation.
Acts as a liaison to post-hospital care providers and community health resources.
Communicates continually with patients, families, medical staff, caregivers, and post-hospital resources.
Facilitates or provides necessary patient and family education prior to admission, during the hospital stay, and after discharge as indicated.
Develops and maintains a positive work climate and positive working relationships with patients, families, medical staff, post-hospital care providers, and community agencies.
Evaluates medical necessity for treatments, procedures, and hospital stays.
Collaborates with insurance companies to obtain authorizations.
Monitors length of stay and identifies potential discharge barriers.
Ensures appropriate use of healthcare resources.
Advocates for patients' needs and preferences with the healthcare team.
Educates patients and families about diagnoses, treatments, and self-care.
Addresses barriers to care such as financial, social, and logistical issues.
Regularly reviews and updates plans based on client progress.
Facilitates referrals to specialized services such as housing, healthcare, and legal aid.
Represents client interests within complex service systems.
Ensures clients receive entitled benefits and services.
Maintains accurate and thorough case management records.
Tracks quality metrics and patient outcomes.
Prepares reports for healthcare teams and administration.
Participates in interdisciplinary care conferences.
Consults with specialists regarding complex patient needs.
Coordinates care plan implementation across disciplines.
Supports the mission, vision, values, policies, and procedures of the organization.
Participates in required education applicable to the position.
Performs other related duties as assigned.
Personal Traits, Qualities, and Aptitudes:
Presents self positively on the phone and in person.
Conveys empathy and compassion in conversation.
Relates to others in a manner which creates a sense of teamwork, cooperation, and confidence.
Works independently and completes assignments as scheduled or communicates barriers to timely completion.
Recognizes the rights and responsibilities of patient confidentiality and handles information appropriately.
Communicates effectively with people from various socio-economic backgrounds.
Relates well to children, adolescents, adults, and geriatric clients.
Qualifications:
Education Required: Graduate of an accredited school of nursing.
Preferred: Previous experience with coordinating community resources for post-acute hospitalization care.
Licenses/Certifications Required: Active RN License, CRASE training.
Preferred: Case Management Certification.
Bilingual and/or English-Spanish speaking preferred.
Ability to work with a culturally diverse population.
Physical Requirements:
Requires sufficient auditory ability to detect and respond to various sounds, including patient alarms and verbal communication.
Clear and effective communication is essential.
Visual acuity is necessary for observing patient conditions and reading documentation.
Requires tactile perception for assessing physical characteristics during patient care.
Motor coordination is required for reaching, grasping, handling, and performing fine motor tasks.
Occasional stooping, kneeling, crouching, or crawling is involved when assisting patients.
Walking and standing are typically continuous throughout the shift.
Requires the ability to lift up to 50 pounds independently and involves frequent pushing, pulling, carrying, or repositioning of objects or patients weighing up to 25 pounds.
May involve occasional lifting or transferring of individuals weighing over 100 pounds.
Working Conditions:
Performed primarily in an indoor healthcare environment, such as a hospital or clinic.
May be subject to variable indoor temperatures.
Frequent exposure to infectious and contagious diseases.
Involves following appropriate safety protocols and utilizing personal protective equipment as required.
The healthcare environment can be fast-paced and unpredictable, requiring the ability to respond quickly to changing circumstances.
Involves multiple simultaneous demands and varying levels of noise due to medical equipment, staff activity, and patient needs.