Nurse III Case Manager

Job Description:
Come work in an environment where we truly value and respect those we serve and believe in the mission that all people can achieve a higher level of wellness and independence.
The state supported living centers serve people with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. The centers provide campus-based direct services and supports at 13 centers located throughout the state.

The state of Texas offers many benefits to employees. HHSC is a qualifying organization for the Federal Public Service Loan Forgiveness Program, which forgives the remaining balance on college student Direct Loans after making qualifying monthly payments. We also offer excellent health benefits, a lifetime monthly retirement annuityas well as (k) and Programs under the Employees Retirement System of Texas.
If you are looking for a place to work where you can establish a career that is filled with purpose, this is the job for you
Free CEUs and updated resources through Lippincott access for all nurses.
The RN Case Manager performs complex nursing work providing for the assessment, care and integrated treatment of individuals residing at the SSLC. Oversees the delivery of nursing care necessary and monitors the health care status to meet the health care needs of individuals assigned to the caseload. As a member of the interdisciplinary team (IDT), works closely and professionally with members of other disciplines to ensure that communication is in place to provide consistent, high quality interdisciplinary and holistic care for all persons served. Performs physical assessments, documents healthcare needs, develops health care plans, oversees the implementing nursing intervention(s), evaluates and analyzes the outcomes of the interventions. Works proactively to ensure optimal health care outcomes for assigned individuals. Reviews available documentation for issues and incidents involving assigned individuals. Performs and reports trend analysis of health care needs and/or issues to the appropriate person and creates nursing care plans that accurately and definitively direct the implementation of all necessary care. Self-initiates to maintain competence in nursing best practices. Uses established nursing methods, procedures and techniques to successfully complete job duties. Attends medical appointments with individuals when need to ensure optimal communication and continuity of care. Participates in quality assurance reviews, attends meetings, mentors and coaches new RN case managers as assigned, and participates in committees and workgroups as assigned. Provides treatment to HHS employees injured in the course and scope of employment as needed. Works under the general supervision of a manager who is a Registered Nurse, with latitude for the use of initiative and independent judgment.
Starting salary for this position: (insert Nurse III market rate for posting SSLC)
Shift statement (use as needed): This position may be eligible to earn additional pay for work performed on evenings, nights and/or weekends.

MSP statement (use as needed): This position may also be eligible to earn additional pay for work performed on maximum security locations.
Essential Job Functions:
Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned. May serve in an on-call status on a rotating schedule as required to meet operational needs of the facility.

Monitors the health status of all individuals assigned to the RN Case Manager. Conducts rounds on the assigned home(s) to gather information from direct support professionals, nursing staff, and others. Observes and interacts with the individuals. Oversees the implementing nursing intervention(s), evaluates and analyzes the outcomes of the interventions. Uses nursing skill and judgment and established procedures to identify current and emerging issues. Documents and follows up on those issues in accordance with protocols. Ensures that proactive nursing care is provided in an attempt to promote the optimal health of persons served. Demonstrates thorough knowledge of the nursing process and nursing procedures. Provides hands-on nursing care as needed, including guidance for LVNs and direct care staff to implement health care plans.

Actively participates as member of the individual’s interdisciplinary team (IDT) as the nursing expert. Participates in proactive problem solving related to care of persons served and nursing processes and issues. Educates others such as the interdisciplinary team members, the Legally Authorized Representative (LAR), the individual, other medical care providers about the individual’s health care plan and status. Works to achieve consensus within the interdisciplinary team. Advocates for the need and preferences of the individual.

Actively participates in, and prepares for in advance, essential meetings related to the individuals on the assigned caseload to manage and coordinate health care. Updates necessary items in the automated system(s) and other tracking documents and takes the necessary action to communicate information to other disciplines.

Performs physical assessments on a monthly, quarterly and annual basis and as needed, in accordance with training and facility protocols. Uses information gathered to develop acute care plans, integrated health care plans, and referrals to health care providers and conveys information gathered to the interdisciplinary team.

Completes required documentation in accordance with schedule (i.e. daily, weekly, monthly, quarterly, annually) and established guidelines and protocols. These include individual plans of care, comprehensive quarterly and annual individualized assessments, and complete physical assessments. Meets required deadlines consistently.

Reviews physician’s orders and Medication Administration Records (MAR) to ascertain that medications/treatments are administered as ordered. Reviews available information for incidents and issues such as emesis, falls, seizures, restraints, and/or injuries. Uses knowledge of medications administered in order to identify desired effects or adverse reactions. Analyzes data for trends and takes appropriate action based on the findings.

Attends on campus medical appointments, treatment and/or clinics with the individual as assigned. When required to coordinate continuity of care, attends off campus medical specialist appointments.

Participates in competency-based training and continuing education activities and meetings to maintain competence in nursing best practice. Demonstrates knowledge of safety and infection control practices to ensure a safe working environment. Complies with state mandated continuing education to maintain licensure as a registered nurse. Follows information security protocols in order to maintain the accuracy and confidentiality of consumer records.

Establishes and maintains professional work relationships with persons served, co-workers, supervisors, ancillary staff and visitors. Mentors and coaches new RN Case Managers as assigned.

Participates in quality assurance reviews and other activities related to the development/enhancement/refinement of nursing policy and procedure in order to evaluate and improve the quality of nursing care provided on campus. Participates in other work groups and committees as assigned.

Provide treatment to HHS employees injured in the course and scope of employment.

Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
Knowledge Skills Abilities:
•Knowledge of nursing techniques, standards, and procedures; of health care laws and regulations; of medical diagnoses and procedures; of accepted medical treatment patterns; of community health and nursing care principles, practices, and procedures; of program regulations and procedures; and of utilization review and control measures.
•Skill in the care and treatment of patients.
•Knowledge of state and federal laws and Intermediate Care Facility for individuals with intellectual disabilities (ICF-IID) rules, regulations, policy and procedures related to State Supported Living Center or ability to quickly gain that knowledge.
•Ability to appropriately interact with individuals with intellectual/developmental disabilities, with their family members, and with staff members.
•Ability to provide patient care; to prepare and maintain records; to interpret policies and procedures; to interpret health care regulations; and to recognize patterns of medical necessity treatment.
•Skills in the use of computer/software and an electronic health record system.
•Skill in time management and prioritization.
•Excellent verbal and written communication skills and the ability to present ideas clearly and concisely in both written and oral communications.
•Ability to work independently and productively with all levels of staff.
•Must maintain current CPR certification. Must have strength and flexibility to safely perform Cardiopulmonary Resuscitation (CPR).
•Knowledge of emergency procedures and emergency equipment, i.e., CPR., and ability to assess and care for residents and/or staff members in emergency situations.
•Knowledge of nursing care standards, the Settlement Agreement and the Healthcare Guidelines or ability to quickly gain the knowledge.
•Ability to interpret regulations and communicate them effectively both orally and in writing.
•Ability and skills to perform comprehensive physical assessments and identify abnormal findings on evaluation and to recognize signs and symptoms of illness or injury.
•Ability to analyze, assimilate, and integrate information in order to make nursing judgments about conditions and the acuity of conditions, to develop plans of care, and to evaluate outcomes of care.

---