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An RN Home Health Case Manager is responsible for planning, organizing, and directing home care services and is well-versed in nursing with an emphasis on community health education and experience. The RN Case Manager is responsible for providing clinical advice and education to patients via telephonic means. Offers intervention, counseling and support services which require clinical knowledge, judgment and nursing skill based upon principles of psychological, biological, physical and social sciences.
Are you passionate about ensuring that all patients receive optimal types and levels of care? This role is responsible for conducting clinical review of authorization requests to identify and determine appropriate types and levels of patient care. This role also facilitates referrals between health plan members, participants, primary care physicians and other health care providers. Do you want to use your nursing degree in a way that positively influences overall patient outcomes? In this role as RN case manager, you will be an integral part of patients’ care and the go-to person in their care delivery programs. You will use your skills and knowledge to manage and coordinate patient care and complex medical needs.
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Perform daily reviews of Inpatient/Observation stays to assure care meets current standards, that level of care is appropriate and apply federal Insurance Guidelines as applicable. Documents inpatient record in a consistent and timely manner to include initial screenings and discharge plan. Performs medical necessity reviews and initial assessment within 24 hours of patient admission. We are here for you every step of the way to help overcome daily challenges of working in the healthcare field.
Help patients receive vital care from the comfort of their residences as a home health case manager. Whether patients are recovering from surgery or managing an injury or long-term illness, home health case managers play a vital role in ensuring their patients are receiving the highest level of care in a setting that fits their needs. They oversee clinical and clerical staff, coordinate care, reinforce policies and expectations, and ensure a positive patient experience. If you’re excited by the prospect of bringing practiced skills to the field of healthcare delivery and its critical extension into the home, you may be interested in this role. These managers oversee the care of patients in their own residences, manage direct care providers, help with treatment planning, and support all involved in the operation.
RN Case Manager Job Summary
Provides ongoing instruction and supervision of client, family or other health team personnel in the plan of treatment. Informing physician and other personnel of changes in the patient’s needs and outcomes of intervention, while evaluating patient and family response to care. Supervision of clinical staff, nurses and home health aides providing care to his/her patients. The primary function of the RN Case Manager is to administer skilled nursing care to an assigned group of patients in their place of residence and to assume the responsibility for their coordination of care.
The nature of the job demands the following skills – excellent observation skills, verbal and written communication skills, problem-solving skills, and nursing skills. Graduation from an accredited school of nursing, with a current license in the state, is mandatory to qualify for this role. Utilizes a combination of agency resources and nationally recognized standards of practice to deliver high quality care and achieve excellent patient specific outcomes. Registered nurses who work as case managers typically have particular qualities that help them be successful, and it is important to include them in your RN case manager job description.
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You should remain in contact with patients during these and subsequent processes. As you consider your preferred type of workplace, you can tailor your studies and experience accordingly. Some common options include general home healthcare businesses and hospice organizations. As you research and home in on a path, you can become well-versed in the regulations, laws, practices, and norms of that particular home health niche. We are looking for nurses that want to make a difference in the lives of their patients and help them live each day to their fullest. We have a great opportunity for an RN Case Manager to work in collaboration with the Patient Care Coordinator and the Interdisciplinary Team in the planning, implementation and evaluation of patient care.
For help in building your job criteria, talk to RNs and other practice staff to get an idea of what they’re looking for in an effective RN case manager who complements their role. Identifies and communicates changes in the patient’s plan of care to the health care team. Attracting the right candidates for a highly complex job such as an RN case manager can be a lengthy, exhausting process. Writing a good job responsibilities section takes a good deal of time and effort out of the recruiting process and can turn your job description from a passive listing into an active tool in candidate selection and screening. The best candidates could pass you by because of an ineffective, poorly written list of duties. Avoid this by approaching your RN case manager job description with a different mentality and rethinking what you choose to include.
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To write an effective home health RN job description, begin by listing detailed duties, responsibilities and expectations. We have included home health RN job description templates that you can modify and use. Meeting with members of healthcare teams to discuss patients' progress, and to deliberate on appropriate care. No matter where you begin your career as a home health case manager, there are certain shared milestones along the way, such as earning a bachelor’s degree. Participates in education programs, quality assessment activities, nurse’s meetings and other staff meetings as required.
What home health agency managers do is complex, multidisciplinary work. Not surprisingly, these highly trained administrators are sought after and generally well compensated in many professional settings. Working with staff members can prove to be a difficult job if case managers do not create effective schedules and delegate responsibilities to others.
Serve as the medical liaison between contracting staff and case managers, interpreting contractual language to determine payment issues and collaborating with all parties to resolve contract issues based on medical appropriateness, as needed. Demonstrates knowledge of Federal/State rules and regulations, ACHC standards, and other regulatory requirements. Implements appropriate nursing clinical programs and initiatives to achieve desired outcomes. Assessing ability of the caregiver to meet the patient’s immediate needs upon admission and throughout care. Needs to review the security of your connection before proceeding. Top 5 RN case manager interview questions with detailed tips for both hiring managers and candidates.
Suggesting and coordinating appropriate follow-up services to promote wellness.
They make use of strong communication skills to work with others, coordinate the efforts of their teams, and ensure positive outcomes for all. The RN Case Manager assures clinical appropriateness of services and efficient use of resources through collaboration with the entire health care team for acute care patients. The RN Case Manager is responsible for medical necessity review, discharge planning, and utilization review. Home healthcare services hinge on making patients feel comfortable and cared for in their homes. As such, home health case managers might interface with patients and their families to discuss outcomes and treatment plans.
You can make those points even more interesting by writing them using action-oriented language, which involves beginning each sentence with an active verb that creates a more involved, vital portrait of the jobseeker’s involvement in daily operations. Top 5 charge nurse interview questions with detailed tips for both hiring managers and candidates. Top 5 nurse manager interview questions with detailed tips for both hiring managers and candidates. Ensuring that patients have transport to and from their homes and all pertinent healthcare facilities.
Case managers must pay close attention to detail and have good analytical skills. They must also stay up to date with advances in healthcare technology. To find success as a case manager, you will need to gain experience in the field of home health.
Observes, records and reports reaction to treatment and any changes in client’s condition to appropriate personnel and/or physician. This website is using a security service to protect itself from online attacks. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. Devising innovative solutions or suggesting appropriate referrals for patients who cannot afford to access treatment. Checking to see whether patients have sufficient insurance coverage or finances to pay for their treatment. Bring us your ambition and we’ll guide you along a personalized path to a quality education that’s designed to change your life.
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