Case Manager RN
2 weeks ago
Moorings Park is looking for a Certified RN Case Manager. The Certified RN Case Manager is responsible for following established policies and procedures and/or specific instructions from the Clinical Manager of Medicare office. The Case manager is responsible for ensuring and coordinating quality and safe delivery of home health services at Moorings Park following applicable licensure/certification requirements both State and Federal. The Case Manager has complete responsibility for the planning, therapeutic interventions, and overall supervision of all Certified cases.
Contributions:
- Performs all initial assessments and comprehensive OASIS assessment on multi-discipline cases, obtain necessary authorizations and consents and develops and institutes the clients’ care plan at admission, resumption of care and recertification visits.
- Evaluate patients’ needs, review all medications. Perform ordered procedures and communicate with other disciplines as appropriate.
- Develop and implement, with physician and patient, an individualized Plan of Care based on patient’s physical, medical, psychosocial, and environmental needs, and make appropriate revisions as the patient’s condition changes. Establish appropriate realistic measurable goals for patients to achieve and evaluate progress toward these goals.
- Supervise the Licensed Practical Nurse (LPN) through instruction on initial Plan of Care as established by the qualified registered nurse. Every thirty (30) days, the Registered Nurse will perform an LPN supervisory visit by making a patient on site visit without the LPN/LVN, and by communicating with the LPN/LVN and reviewing documentation. When indicated, the Registered Nurse will make an on-site visit with the LPN/LVN; for certified only.
- Provide services requiring professional nursing skill, including administration of medications, treatments, and procedures in acceptance with standard nursing practice.
- Observe and report signs, symptoms, and progress of patient to physician.
- Coordinate services, informing physician and other interdisciplinary team members of changes in the patient's condition and needs.
- Instruct/counsel patients and family in meeting patient’s needs, promoting self-care and independence.
- Keep current and adequate documentation showing assessment of the patient’s status, response to treatment, teaching and training, and treatments provided.
- Identify patients who would benefit from the services of a Home Health Aide and obtain physician's approval.
- Supervise Home Health Aide:
- Prepare Home Health Aide assignment sheet / written instructions indicating care and tasks to be performed.
- Communicate regularly with the Home Health Aide.
- Make and document Home Health Aide supervisory visits no less than every 14 days and non-skilled no less than every 30 days to:
- Evaluate effectiveness of Home Health Aide care provided.
- Rapport with patient/ family
- Infection control procedures
- Honoring patient rights
- Following Home Health assignment sheet
- Revise Home Health Aide assignment sheet/ written instructions as necessary.
- Complete a comprehensive OASIS Recertification/Follow-up Assessment along with other recertification documentation, as appropriate, for certified and a head-to-toe assessment for Private Duty.
- Complete a comprehensive OASIS Resumption of Care Assessment along with other resumption documentation, as appropriate for certified and a head-to-toe assessment for Private Duty.
- Complete a comprehensive OASIS Discharge Assessment if nursing is the last skilled discipline providing service.
- The nurse may accept verbal and telephone orders from the physician involving any changes or additions in the original Plan of Care, followed by sending them to the physician for signature.
- Participate in Patient care conferences, interdisciplinary coordination of care, in-service education, and QAPI program.
- Coordinate care of services with other involved and authorized organizations and individuals.
- Plan and prepare the patient for discharge.
- Participate in the 24-hour On-Call service.
- Assures medical necessity as appropriate and homebound status.
- Attends In-service programs.
- Maintains and enhances clinical skills through continuing education.
- Provides leadership and direction to ancillary (LPNs, HHAs) personnel as assigned.
- Maintains cooperative manner towards client/family and all members of the health care team.
- Excellent oral and written communication skills in the English language required
- During emergencies or natural disasters may be required to be on duty for the duration of the disaster.
- Registered Nurse graduate from an accredited nursing program.
- Certifications and Licensed Registered Nurse and other licensure required by state regulations
- Previous geriatric or home care background
- Home Health Agency experience preferred.
- A minimum of two years supervisory experience required.
Moorings Park ® Communities, a renowned Life Plan organization includes three unique campuses located in Naples, Florida. We offer Simply the Best® workplaces through a culture of compassionate care for both our residents and our partners. We’re proud to be named a Great Place to Work Certified company through Fortune "100 Best Companies to Work For®".
Simply the Best Benefits for our partners include:
- FREE health and dental insurance
- FREE Telemedicine for medical and behavioral health
- Vision insurance, company paid life insurance and short-term disability.
- Generous PTO program
- HSA with employer contribution
- Retirement plan with employer match
- Tuition reimbursement program
- Wellness program with free access to on-site gym
- Corporate discounts
- Employee assistance program
- Caring executive leadership
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