The Registered Nurse (RN) Case Manager for Home Health provides nursing care in accordance with the client's plan of care, and includes comprehensive health and psycho-social evaluation, monitoring of client's condition, health promotion and prevention, coordination of services, teaching and training activities and provision of direct nursing care and other duties as deemed necessary.
- Conducts the admission of the patient when necessary.
- Obtains a medical history, particularly as it relates to the present condition, from the patient and/or family member(s).
- As needed, performs comprehensive assessment to include OASIS, evaluation of home situation to determine what health teaching will be required and services needed.
- Develops and updates the plan of care in consultation with the physician and all clinicians who perform the comprehensive assessments for the client.
- Participates in the patient's discharge planning process.
- Provides skilled nursing care as needed in accordance with the plan of care.
- Prepares and presents patient's record at case conference as indicated.
- Cooperates with other agencies providing nursing or related services to provide continuity of care and to implement a comprehensive care plan.
- Always strives to improve nursing care by attending in-service education, through formal education, attendance at workshops, conferences, active participation in professional and related organizations and individual research and reading.
- Responsible for the overall clinical record maintenance to include visit note documentation be completed within 24 hours, comprehensive assessments, including OASIS be completed within 48 hours, medication profile updated timely, orders/plans of care submitted timely, etc.
- Maintains confidentiality of patients’ private health information.
- Supervises and evaluates the Home Health Aide Care Plan in conjunction with the clinician establishing the aide care plan.
- Supervises that the aide supervisory visits are conducted every 14 days and when necessary, performs such supervisory visit.
- Supervises that LVN supervisory visits are concluded monthly and when necessary, performs supervisory visits. Also, supervises communication with LVN is documented twice monthly concerning client status.
- Graduation from an accredited School of Nursing.
- Current license in the state of Texas.
- Current CPR certification.
- One or more years in a Home Health agency or hospital, Home Health experience required.
Job Type: Full-time
- Dental insurance
- Disability insurance
- Employee assistance program
- Free parking
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
- Monday to Friday
- RN License (Required)
- CPR Certification (Required)
- Driver's License (Required)