We are currently seeking an experienced RN/MDS Case Manager.
Job Responsibilities:
- Provide admission, case management, and follow-up skilled nursing visits for skilled nursing residents’ home health patients.
- Administer ongoing care and case management for each patient, providing necessary follow-up as directed by the Clinical Manager.
- Confer with the physician in developing the initial plan of treatment based on physician's orders and initial patient assessment.
- Provide hands-on care, management, and evaluation of the care plan, and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision.
- Revise the plan in consultation with the physician based on ongoing assessments and as required by policy/regulation.
- Coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Home Health Aides, and external providers).
- Report patient care/condition/progress to the patient's physician and Clinical Manager on a continuous basis.
- Implement the patient care plan in conjunction with the patient and family to assist them in achieving optimal resolution of needs/problems.
- Monitor the appropriate completion of documentation by personal care workers as part of the supervisory/leadership responsibility.
- Discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation.
- Prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes.
- Prepare visit/shift reports, update/summarize patient records, and confer with other healthcare disciplines in providing optimum patient care.
Required Experience/Skills:
- Diploma, Associate, or Bachelor Degree in Nursing.
- A minimum of two years of case management experience preferred. Current Registered Nurse licensure.
- Current CPR certification. Strong organizational and communication skills.
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