RN Case Manager Home Health - Cobb County
Company: Wellstar Health System
Location: Norcross
Posted on: October 3, 2024
Job Description:
Facility: 1800 Parkway CenterJob SummaryThe Cobb County RN Case
Manager is responsible for providing and supervising primary care
to approximately 25-35 patients in their home setting. This
includes age appropriate interventions that meet physical,
emotional, developmental, psychosocial and educational needs. The
RN Case Manager is responsible for the coordination of all
disciplines throughout the episode of care. The RN Case Manager
communicates with all team members including RNs, LPNs, Therapists,
Social Workers, Home Health Aides, the Physician, patient, family,
and other internal or external individuals to ensure that the
patient's plan of care is appropriately developed, implemented and
that goals are met. The RN Case Manager supervises the LPNs and
Home Health Aides throughout the patient plan of care. The RN Case
Manager participates with leadership to develop and implement
processes to continue improvement with patient and agency
outcomes.Core Responsibilities And Essential FunctionsDIRECT
PATIENT CARE
- Assesses, coordinates with other disciplines and manages
patient's total needs, following physician's orders, using the
nursing process
- Develops patient's plan of care coordinating with other
disciplines
- Manages patient from admission through recerts to discharge and
appropriately scheduling visits per physician's order: adjust
frequency as needed, based on patient clinical status and MD
order
- Performs routine and complex nursing procedures to meet the
need of the patient 30% COORDINATION OF SERVICES FOR EPISODE OF
CARE
- Revises the plan of care based on patient need within physician
orders, coordinating with other disciplines to ensure goals are met
to achieve positive outcomes prior to discharge
- Supervises LPNs and Home Health Aides throughout the continuum
of care.
- Develops and supervises the care plan provided to the Home
Health Aides
- Reviews Plan of Care for patients with the Manager Home Health
and other team members and support services
- Maintains communication with physician reporting any changes
that may affect the patient's recovery 20% PATIENT / CAREGIVER
EDUCATION Provides patient/caregiver education to develop and
encourage self care to achieve positive outcomes Utilizes both
verbal and written tools to facilitate learning and promotion of
independence during recovery Be aware and report concerns to
authorities or agency leadership on any issues that affect patient
or staff safety 15% STAFF EDUCATION AND PROFESSIONAL
DEVELOPMENT
- Participates in the orientation and education of new employees
as appropriate
- Responsible for attending continuing education and in-services
as directed and needed
- Responsible to remain current in clinical knowledge for the
care of the home health patient
- Receives training, supervision or direction from leadership as
needed 5% COMMUNICATION
- Communicates patient status changes and lab results to the
physician as appropriate .
- Participates in care team conferences
- Responsible for checking voice mail box and staff messaging a
minimum of once daily 10% REGULATORY GUIDELINES
- Demonstrates knowledge and appropriate application of
CMS/State, and Joint Commission regulatory guidelines.
- Responsible for accurate completion of required OASIS and visit
documentation in the patient's EMR
- Completes all documentation within established timeframes 10%
SUPPORTS AND PARTICIPATES IN PERFORMANCE IMPROVEMENT
ACTIVITIES
- Participates in department performance improvement activities
(i.e. chart review, committees, etc.).
- Participates in system-wide committees as requested.
- Identifies methods for improving department
performance/care.
- Assists in implementing performance improvement opportunities
5% OTHER RESPONSIBILITIES
- Meets established productivity standards
- Weekend and call rotation as required
- Perform other duties as assigned by Home Health Leadership
5%Required Minimum EducationGraduate of an approved school of
professional nursing, RequiredRequired Minimum License(s) And
Certification(s)All certifications are required upon hire unless
otherwise stated.
- Reg Nurse (Single State) or RN - Multi-state Compact
- Basic Life Support or BLS - InstructorAdditional License(s) And
Certification(s)Required Minimum Experience:Minimum 1 Year Of
Medical/Surgical Nursing Required AndHome Health, and ICU
experience Preferred andMust possess extremely strong critical care
nursing skills.RequiredRequired Minimum Skills:Strong Critical Care
Assessment And Clinical Skills Required.Positive leadership,
problem solving skills, strong organizational and time management
skills.Strong communication (written and verbal) skills.Ability to
write and follow directions to patient's homes.Use of Windows based
computer, utilizing home health patient software, email, internet,
computer based learning modules, etc.Good understanding of home
health operations, reimbursement, law and regulatory
processes.OASIS knowledge preferred.
Keywords: Wellstar Health System, Athens , RN Case Manager Home Health - Cobb County, Executive , Norcross, Georgia
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