POSITION TITLE: Registered Nurse Case Manager
REPORTS TO: Patient Care Manager
FLSA: Exempt
Position Scope:
The Registered Nurse, under the direction of the Patient Care Manager, provides skilled nursing care to individuals and families. Plans, implements and evaluates nursing care through systematic assessment of patient/family needs. The RN is responsible for the coordination of the plan of care for all patients.
Reasonable Accommodations Statement
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable Accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
I. Essential Functions/Performance Factors
- Uses the nursing process in the initial and ongoing assessment of the impact of the terminal diagnosis on the patient's physical, functional, psychosocial and environment needs and activities of daily living.
- Complete the initial nursing assessment within agency time frame.
- Initiate appropriate preventive and rehabilitative nursing procedures.
- Determine the scope and frequency of services needed based on acuity and patient/family needs.
- Provide ongoing evaluation of patient/family response to care.
- Apply specific criteria for admission and re-certification to hospice care to establish appropriate levels of care and the patient’s eligibility.
- Prepares clinical and progress notes that demonstrate progress toward established goal(s).
- Complete documentation of each nursing visit within 24 hours of visit.
- Complete the NAR accurately.
- Write nursing notes that reflect the patient’s terminal illness according to NHPCO guidelines, local Medical Review policies and the care plan.
- Sign all entries with full signature and credentials.
- Provide care/medications in accordance with a physician’s order.
- Chart to reflect the nurse’s role as case manager.
- Document change in status accurately and complete this documentation within 24 hours.
- Complete the discharge summary within agency time frame and reflect an overview of the care provided.
- Complete Palmetto/Cahaba LCD Guidelines Worksheets accurately at the time of admission and at every recertification.
- Implements the individualized plan of care and recommends revisions to the plan as necessary.
- Manage discomfort and provide symptom relief.
- Utilize specialized nursing skills related to palliative and end-of-life care.
- Assess patient’s physical condition with each visit and document findings.
- Complete pain assessment thoroughly with each visit.
- Identify other symptoms and treat appropriately.
- Continually evaluate the effectiveness of nursing interventions and make appropriate changes to the care plan.
- Attend weekly team meeting and update team members regarding patient’s condition, care needs, and response to nursing interventions.
- Update the care plan based on the needs of the patient/caregiver, or at least every two weeks.
- Makes visit per medicare guidelines of minimal one visit every 14 days.
- Coordinates all patient/family services and prioritization of needs with the members of the IDT.
- Use case management approach and refer to other services as needed.
- Inform the physician and other personnel of changes in the patient’s needs and outcomes of intervention.
- Supervise LPNs and paraprofessionals providing services to the patient according to regulatory guidelines.
- Assess the ability of the caregiver to meet the patient’s immediate needs upon admission and throughout care.
- Communicate information using current process and technology available to the organization.
- Visit hospitalized patients as per agency standard to ensure continuity.
- Participates in on-call rotation.
- Uses agency resources wisely.
II. Participates in performance improvement activities.
Values Ownership/Performance Factors
- Teamwork: Support and encourage my teammates throughout the organization.
- Integrity: Be reliable, allowing others to place their trust in me.
- Performance: Be flexible and willing to adapt to change.
- Spiritual: Recognize the spirituality inherent in each individual without judgement.
- Mission Focused: Recognize the value of each person and accept that value without judgment.
- Engagement: Focus my physical, emotional, and spiritual energy in order to fulfill our mission.
Supervisor Responsibilities:
None
Education and Work Experience:
- Minimum of 18 months registered nursing experience; home health, medical surgical or hospice nursing preferred.
- Graduate of an accredited school of nursing.
- Evidence of clinical experience and skills necessary to perform job.
- Exhibits excellent communication skills.
Certifications and Licenses:
- RN, WV and OH.
- Certified Hospice & Palliative Care Nurse (CHPN) after two years of hospice experience.
- Current driver’s license, automobile insurance, and reliable transportation.
Confidentiality:
The Registered Nurse must carry out responsibilities in an ethical, professional and confidential manner.
PHYSICAL DEMANDS
- Stand: O (Occasionally)
- Walk: O (Occasionally)
- Sit: O (Occasionally)
- Handling / Typing: F (Frequently)
- Reach Outward: O (Occasionally)
- Reach Above Shoulder: O (Occasionally)
- Climb: O (Occasionally)
- Crawl: N (Not Applicable)
- Squat or Kneel: O (Not Applicable)
- Bend: O (Not Applicable)
- 10 lbs or less: O (Occasionally)
- 11-20 lbs: O (Occasionally)
- 21-50 lbs: O (Occasionally)
- 51-100 lbs: O (Occasionally)
- Over 100 lbs: N (Not Applicable)
- Push/Pull: 12 lbs or less: O (Occasionally)
- 13-25 lbs: O (Occasionally)
- 26-40 lbs: O (Occasionally)
- 41-100 lbs: N (Not Applicable)
- Other Physical Requirements: Sense of Sound, Sense of Touch, Sense of Sight.
WORK ENVIRONMENT
While performing the duties of this job, the employee frequently is exposed to outside weather conditions when traveling between sites. Patients’ home environments are variable with regard to heat, noise, air circulation and conditioning, space, cleanliness, accessibility and all other environmental factors. Inpatient and skilled nursing facility environments are standardized. Office environment in a controlled atmosphere building.
Job Type: Full-time
Pay: $65,000.00 - $72,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Schedule:
Experience:
- nursing: 2 years (Preferred)
License/Certification:
Work Location: On the road
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