RN Case Manager
3 weeks ago
Location: Oak Ridge, TN
Full-Time, Monday- Friday
*On-Call one (1) week of the month
Here's Why Our Team Likes Working with Us:.
- Medical, dental, vision, and 401K
- Supplemental insurance available
- Matching 401k
- Unlimited Paid Time Off (PTO)
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Employee must have regular attendance/punctuality, be able to work with others at all levels of the Company, have exceptional customer service, and demonstrate a comprehensive in-home clinical knowledge base. Other assigned duties include:
- Provides accurate and complete documentation with rationale to ensure reauthorization of patients.
- Delivers services in the field or away from assigned office 50% of the time. Field activities include tasks such as: in-home RN scheduled visits, attending physician appointments.
- Assists in the implementation of the Plan of Care ('POC') and any amendments to the POC as needed.
- Conducts the orientation of new staff and coordinates them starting in patients' homes.
- Serves as a resource to new staff for training and follow up after training to ensure staff satisfaction and retention.
- Submits all nursing documentation timely per company policy
- Completes assigned chart reviews as assigned within established time frames and follows up and councils' staff on documentation issues as necessary and ensure documentation is turned in on time.
- Establish and promote a collaborative relationship with patient, physicians, payers, and other members of the healthcare team.
- Assist authorization team to collect and communicate pertinent, timely information to payers to ensure reauthorization of patient's home health care services.
- Actively involved in the process improvement activities to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
- Participates in assigned quality assurance committee(s) and interdepartmental projects when needed or requested.
- Demonstrates current knowledge of Payor policy and procedure(s).
- Assist with state survey preparation and implementation and act as the back up administrator as assigned.
- Other duties as assigned.
SUPERVISORY RESPONSIBILITIES
This position has direct supervisory responsibilities. This position will perform supervisory visits as needed.
Requirements
QUALIFICATIONS: 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.
EDUCATION and/or EXPERIENCE
Required
- Bachelor's degree in a related field
- Current Registered Nurse (RN) license to practice professional nursing in each state where patient care is supervised
- Current Basic Cardiac Life Support certification
- At least one (1) year of case management experience
- At least one (1) year of staff scheduling experience
- Three (3) or more years of experience as a Registered Nurse preferred
- Nurse management or supervisory experience preferred
- Home health or Department of Labor (DOL) experience strongly preferred
CERTIFICATES, LICENSES, REGISTRATIONS, & MEDICAL REQUIREMENTS•
- Valid Driver's License
- Active RN License
The following background checks are conducted:
- Criminal background
- Driving Record
- OIG Exclusion List
- Sex Offender Registry
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