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RN Case Manager

Status Interviewing
Type Full Time
Location Galion, Ohio
Company Info Avita Home Health and Hospice
1220 North Market Street
Galion, OH 44833
Description CASE MANAGER ESSENTIAL DUTIES AND RESPONSIBILITIES: Collaborates proactively with interdisciplinary team members maintaining a patient/caregiver/family centered focus to facilitate and maximize patient health care outcomes. Schedules and coordinates patient care visits required by Registered and Licensed Practical Nurse staff. Directs the coordination of patient care to ensure the educational and nursing goals for patient are achieved. Ensures the timely completion of OASIS assessments, re-certifications, HH Aide, Homemaker, Personal Care Aide, and LPN supervisory visits by RN staff are completed according to agency policy and federal regulations. Reviews the appropriateness of patient care, progress toward goals and makes suggestions for changes in the patient care plan as needed. Gives and receives reports on patients daily to ensure coordination of care. Case Managers will integrate factors related to quality, safety, efficiency, and cost effectiveness in planning, delivering, monitoring, and evaluating patient care promoting the most effective and efficient use of human and financial resources. Case Managers function as liaison between referral sources, physicians, visiting staff regarding patient needs and coordinates care from other providers as needed. Case Managers develop, implement and coordinate the discharge plan for patients. Collaborates with other members of the health care team, the patient, caregiver and/or family, to develop and implement and carry out the discharge plan. Accurately collects patient information from referral sources including such information as name, address, date of birth, emergency contact, physician, services or supplies requested and company responsible for payment of bill. Communicates agency policies such as visiting schedules, payment of accounts, schedule of charges, alternate services available, and insurance regulations/coverage issues to patients, families and referral source. Completes patient intake forms – communicates information to Clinical Manager for assignment. Communicates with third party payors to arrange for coverage of services, including verification of coverage, service requirements, patient requirements, and billing requirements. Coordinates interdisciplinary needs of the patient, making referrals to PT, ST, OT, LSW, and to IV vendors, DME supplier, and other related services needed at time of admission. Routes copies of patient information to designated departments. Responsible for understanding Medicare, Medicaid, and other third party regulations, and staying current with any regulation changes as they occur. Understands agency policies related to patient care and financial issues. Triages phone calls from patients or on their behalf and follows up appropriately to the situation. (Confirms scheduled visit, delivery of supplies, confers with Clinical Manager when conflicting scheduling needs arise, etc.) Accepts verbal physician orders, transcribes order and relays orders to visiting nurse, and places copy in patient field chart. Identifies and completes the appropriate OASIS data and is knowledgeable of time requirements for data collection at Start of Care, Follow-up, Transfer, Discharge and Death at Home and meets time requirements as specified. Assigns patient record number. Compiles data as requested by the Clinical Manager or designee. Assists with recertification paper work for patients every sixty (60) days. Functions as staff nurse on an occasional basis when a team member is absent, or as needed. Accepts on call assignments as requested. Participates on the Performance Improvement (PI) Committee and completes assigned PI monitoring or projects. Understands and supports the agency’s mission, vision, and core values. Assumes responsibility for personal growth and development and maintains and upgrades professional knowledge and practice skills through attendance and participation in continuing education and inservice classes. Must have knowledge of and comply with agency policies and procedures to meet the requirements including OSHA, Exposure Control Plan, TB Control Plan, Bloodborne Pathogen Standard, Hazard Communication Program, HIPAA, and all other applicable regulations. Complies with home health agency policies/procedures, including maintaining confidentiality of all patients and agency issues in accordance with HIPAA regulations. Complies with regulations pertaining to patient service eligibility and service delivery for Medicare, Medicaid, and other payor sources. Communicates with the supervisor immediately when unclear on regulations whether related to patient care, documentation, billing, or in other areas. Complies with agency procedure that will ensure the accuracy of all patient bills remitted to third party payors. Communicates to supervisor or with the compliance officer immediately, if at any time they feel that another employee may be violating or are being requested to violate agency policies or government regulations (i.e. Medicare, Medicaid, or other regulatory bodies). Complies with agency procedures what will ensure the accuracy of all patient bills This job description in no way states or implies that these are the only duties to be performed by this employee. He/She will be required to follow any other instructions and to perform any other work-related duties requested by his/her supervisor. 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. EDUCATION and/or EXPERIENCE: A graduate of an accredited school of Nursing; minimum of one year experience as a nurse. LANGUAGE SKILLS: Ability to communicate effectively and present information accurately and respond to questions from managers, clients, customers, and the general public. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures or government regulations. Ability to write reports, business correspondence, and procedure manuals. MATHEMATICAL SKILLS: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and interpret bar graphs. REASONING ABILITY: Ability to apply common-sense, understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. The employee must have the ability to react quickly and think clearly in the event of an emergency. The employee must have the ability to learn new procedures and updated clinical nursing skills as the need arises. CERTIFICATES, LICENSES, REGISTRATIONS: Must have a valid Ohio driver’s license, a car in good working condition with car liability insurance as required by the Operations Committee. A current RN license to practice nursing in the state of Ohio, as well as continuing education requirement per Ohio Board of Nursing renewal requirements to maintain licensure. Must maintain current CPR certification. OTHER SKILLS and ABILITIES: ORGANIZATIONAL SKILLS: Is motivated and self-directed and has the ability to work with little supervision. Is flexible and cooperative. Communicates effectively both orally and in writing. Organizes and manages time effectively. PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. HEALTH REQUIREMENTS: Has completed employment physical within 30 days of employment, including physician certification of ability to carry out physical job functions. While performing the duties of this job, the employee is frequently required to sit and talk or hear. The employee frequently is required to use hands to finger, handle, or feel objects, tools, or controls and reach with hands and arms. The employee is occasionally required to stand. The employee must frequently lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, depth perceptions, and the ability to adjust focus.
How to Apply
Date Posted Friday, June 19, 2020

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