Registered Nurse Case Manager - Home Health
Company: Residential Home Health and Residential Hospice
Posted on: August 14, 2019
Job TitleRegistered Nurse Case Manager - Home
HealthLocationHarrisburg, PA, USAEmployee TypeEmployeeWorking Hours
Per Week40Job Functional Area
SUMMARY: The RN will coordinate the home care of chronically ill
patients by utilizing a disease management process, the OASIS
assessment, plan of care and established protocols. Will also
educate the patient/caregiver in the management of their illness
and promote the home health support systems to decrease
re-hospitalization and utilization of hospital emergency
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other
duties may be assigned as necessary.
--- Review the home health referral, updating & communicating any
changes to other disciplines and to customer service center.
--- Perform assessments within 24-48 hours of receiving a
--- Complete Start of care papers and forward to the office
--- Develop rapport with the client and family ensuring privacy and
confidentiality while obtaining accurate client history.
--- Complete a physical assessment and communicate the findings and
plan of care to the physician.
--- Initiate evaluations to other disciplines
(PT,OT,HHA,SLP,MHRN,MSW) or support services when indicated.
--- Conduct Home health aide supervisory duties as required by
--- Document accurately and appropriately on the laptop during each
visit, uploading by midnight.
--- When appropriate, enter insurance authorization requests within
24 hrs of initial evaluation and continue to enter additional
requests at the end of each authorization period.
--- Organize daily assignments, setting priorities based on
individual and overall needs of the clients while traveling to each
home as scheduled.
--- Ensure the clients have prescribed medications and/or treatment
supplies, updating file as changes occur.
--- Identify appropriate actions that will provide for continuity
of care, an individualized teaching plan and the involvement of the
individual and family/caregiver whenever possible.
--- Formulate a plan of care to achieve expected outcomes through
short and long term goals that are realistic and feasible in terms
of resources, time, material, people and cultural relevancy. Revise
the plan of care in response to changes in the individual's status
or to adjust to the individual's response to care, and communicate
and update with all disciplines, including PPL.
--- Coordinate discharge planning with direct involvement of
--- Document any communication and/or orders from the
--- Attend PCH/ALF case conferences as scheduled providing weekly
client reports to team and provide PCH/ALF monthly educational
inservices as requested by facility.
--- Maintain a high level of competency, growth and development,
including ensuring license and CPR are current and in good standing
at all times.
--- Attend nursing staff meetings, quarterly educational
in-services and yearly competency day.
--- Perform on-call duties per agency requirements/assignment for
non-business hours. Position may require after hours patient visits
to achieve positive patient outcomes.
--- Follows agency policies and procedures as per the Policy and
Procedures of the company.
--- Adhere/assist with company outcome goals as indicated by
QI/home health compare tracking.
--- Follow guidelines as indicated in employee handbook
--- Participate in QA/OBQI initiatives with problem-solving via
--- Perform other duties as assigned by management.
QUALIFICATION REQUIREMENTS: To perform this job successfully, an
individual must be able to perform each essential duty
satisfactorily. The requirements listed below are representative of
the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities
to perform the essential functions.
--- Must be able to meet the physical demands of providing nursing
care, ambulating patients, transferring patients, assisting with
--- Must be able to transfer patients as needed according to proper
techniques of body mechanics to promote patient and staff
--- Must be able to use good and sound clinical judgment.
--- Must be able to document accurately and appropriately.
--- Must follow up as needed and appropriately with doctor's
office, clinical and management staff pertaining to any concerns
regarding patient care.
--- Must hold, in good standing, a license as a Registered Nurse,
issued by the state in which you work
--- CPR certified.
--- Must be empathetic, non-judgmental, tactful, responsible, and
--- Must understand the team approach and be a supportive team
EDUCATION and/or EXPERIENCE:
--- Must possess an Associate Degree from an accredited School of
--- A minimum of two (2) years of experience working as a
Registered Nurse including some medical/surgical experience and/or
an acute care or home care setting is preferred.
Education & Certifications
CompanyResidential Home Health of Carlisle, Inc.Graham Healthcare
Group is an Equal Opportunity Employer
Keywords: Residential Home Health and Residential Hospice, Harrisburg , Registered Nurse Case Manager - Home Health, Executive , Harrisburg, Pennsylvania
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