RN Case Manager

Description

Full Time

Compensation: $73,000 per year

SUMMARY

On behalf of Critical Nurse Staffing, LLC (“CNS” or “Company”), the RN Case Manager is responsible for overseeing the delivery of coordinated care for a patient and/or an assigned group of patients. Additionally, this position is responsible for the day-to-day management and supervision of the related clinical care activities within the area the Case Manager services.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Employee must have regular attendance/punctuality, be able to work with others at all levels of the Company, have exceptional customer service, and demonstrate a comprehensive in-home clinical knowledge base. Other assigned duties include:

1. Provides accurate and complete documentation with rationale to ensure reauthorization of patients.
2. Delivers services in the field or away from assigned office 50% of the time. Field activities include tasks such as: in-home RN scheduled visits, attending physician appointments.
3. Assists in the implementation of the Plan of Care (‘POC’) and any amendments to the POC as needed.
4. Conducts the orientation of new staff and coordinates them starting in patients’ homes.
5. Serves as a resource to new staff for training and follow up after training to ensure staff satisfaction and retention.
6. Submits all nursing documentation timely per company policy
7. Completes assigned chart reviews as assigned within established time frames and follows up and councils’ staff on documentation issues as necessary and ensure documentation is turned in on time.
8. Establish and promote a collaborative relationship with patient, physicians, payers, and other members of the healthcare team.
9. Assist authorization team to collect and communicate pertinent, timely information to payers to ensure reauthorization of patient’s home health care services.
10. Actively involved in the process improvement activities to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
11. Participates in assigned quality assurance committee(s) and interdepartmental projects when needed or requested.
12. Demonstrates current knowledge of Payor policy and procedure(s).
13. Assist with state survey preparation and implementation and act as the back up administrator as assigned.
14. Other duties as assigned.

SUPERVISORY RESPONSIBILITIES

This position has direct supervisory responsibilities. This position will perform supervisory visits as needed.

Requirements

QUALIFICATIONS: 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.

EDUCATION and/or EXPERIENCE

Bachelor’s degree in a related field, current Registered Nurse (RN) license to practice professional nursing in each state where patient care is supervised, current Basic Cardiac Life Support certification

RELATED COMPETENCIES

Language Skills: Must be able to read, analyze, and interpret general business practices, policies and procedures, professional journals, technical guidelines, and governmental regulations. Must be able to write reports, business correspondence, and procedure manuals. Must be able to effectively present information and respond to questions from groups of managers, clients, customers, and the public. Must be able to accurately and clearly provide guidance and direction to Company staff and employees.

Business Acumen: Through the use of related law and industry data, proactively identify Company risks and institute policies and/or procedures to ensure compliance.

Decision Making: Identify and understand issues, problems, and opportunities; possess ability to analyze data from different sources to draw conclusions; utilize effective approaches for choosing a course of action or developing appropriate solutions; take action that is consistent with available facts, constraints, and probable consequences.

Other Requirements: Maintain current state licensure. Maintain current liability and malpractice insurance, if applicable.

CERTIFICATES, LICENSES, REGISTRATIONS, & MEDICAL REQUIREMENTS

· Valid Driver’s License

· Active RN License

CLEARANCES

The following background checks are conducted:

· Criminal background · Drug Screening

· Driving Record

EXPOSURE CATEGORY: [ 2 ]

1) - Job tasks involve exposure to blood, body fluids, or tissue.

2) - Job tasks involve no exposure to blood, body fluids, or tissue, but employment may require unplanned category 1 exposure.

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.

Mobility:

· Must be able to stand 33% of the time; sit 34% of the time; walk 33% of the time.

· Climbing (ascends or descends ladders, stairs, scaffolding, ramps, etc., using feet and legs and/or hands and arms).

· Balancing (maintaining body equilibrium to prevent falling when walking, standing, crouching, or running on narrow, slippery, or erratically moving surfaces).

· Stooping (bending body downward and forward by bending spine at the waist).

· Kneeling (bending legs at knees to come to rest on knee or knees).

· Crouching (bending body downward and forward by bending legs and spine).

· Crawling (moving about on hands and knees or hands and feet).

· Reaching (extending hand(s) and arm(s) in any direction).

Dexterity:

· Handling (seizing, holding, grasping, turning or otherwise working with hand or hands).

· Fingering (picking, pinching, or otherwise working primarily with fingers).

· Feeling (perceiving attributes of objects, such as size, shape, temperature, or texture, by touching with skin, particularly that of the fingertips).

Lifting:

· Must be able to exert up to 50 pounds of force to lift and carry objects.

Communication:

· Must be able to express or exchange ideas by means of the spoken word. Must be able to clearly communicate with others by way of the English language.

· Must be able to communicate via multiple platforms (e.g., email, letter, telephone, video conference, etc.).

Hearing:

· Must be able to perceive the nature of sounds at normal speaking levels with or without correction. Must be able to receive detailed information through oral communication, and to make the discriminations in sound.

Taste/Smell: This position does not require the ability to taste and/or smell.

Vision: Must have the following vision abilities:

· Close vision (clear at 20 inches or less).

· Far vision (clear at 20 feet or more).

· Depth perception (Three-dimensional vision. The ability to judge distances and spatial relationships so as to see objects where and as they actually are.)

· Ability to adjust focus (ability to adjust the eye to bring an object into sharp focus).

· Field of vision (observing an area that can be seen up and down or right or left while eyes are fixed on a given point).

Physical effort:

· Light work (moderate physical activity required by handling objects up to 50 pounds occasionally and/or up to 20 pounds frequently).

WORK ENVIRONMENT The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of this job.

Physical surroundings:

· 80% of time is spent indoors; 20% of time is spent outdoors.

· The noise level is usually low to moderate.

· Air pollution may be moderate. Exposure to secondhand smoke or other air pollutants is possible.