Case Manager

Case Manager

Requirements

• Graduate of an accredited school of professional nursing
• Minimum of two (2) years management experience in Home Health or related health care organization
• Graduate of a 4-year medical related degree
• Must be a licensed driver with an automobile that is insured in accordance with state and agency requirements and is in good working order
• Required Training: HIPAA Privacy Course
• Required Training: HIPAA Security Course

Responsibilities

• Manages and directs a team of Field staff ensuring safe, effective, and appropriate home care
• Receives referrals, determines services required, and Agency’s ability to meet needs. Assigns appropriate clinicians to
• Meets with clinical staff on a regular basis to provide guidance and information related to specific issues. Provides direction to teams to assure that client needs are met, and services are provided according to the plan. Assists clinical staff in establishing priorities, setting goals, and evaluating progress toward
• Attends case conferences and other clinical meetings to facilitate coordination of
• Reviews monthly team members’ productivity
• Coordinates 24-hour Agency coverage by Registered Nurses. Evaluates quality of on-call
• Provides on-call backup for Case Managers, as needed
• Develops working relationships with other health care professionals in the community and families to identify resources available and to ensure access of information to clients
• Provides support and direction to Agency staff, other health care professionals, clients, and families related to appropriate and available health care
• Educates Agency staff on clinical services, policies, and procedures as needed
• Facilitates problem-solving sessions to enable Field Staff to resolve client and/or reimbursement source issues
• Stays current on available community resources, health care costs, and industry trends through self-education and access to outside educational resources
• Ensures accuracy, completeness and timeliness of clinical documentation in accordance with Agency policies and procedures, regulatory requirements and industry standards
• Monitors open and closed charts regularly and participates in the quarterly clinical record review
• Reviews Agency policies and procedures and recommends changes or revisions as needed
• Provides educational programs and information regarding appropriate documentation
• Provides leadership to team and support staff in identifying Agency/client needs and opportunities for quality improvement
• Assists quality improvement teams with data collection for the Quality Improvement Plan established by the Agency
• Reviews OASIS data collection to assure accuracy and consistency with requirements. Communicates with clinicians and provides training as indicated to achieve compliance with collection and reporting
• Identifies and implements changes in clinical and/or operational practice based on the findings of the Quality Improvement
• Interprets and enforces human resource policies and procedures in a fair and consistent manner
• Assists in the orientation of new staff
• Follows Agency guidelines for disciplinary actions. Documents all disciplinary actions in accordance with Human Resource policies and legal requirements
• Collaborates with Agency Director and other clinical management staff to ensure proper staffing of qualified, competent personnel
• Promotes personal safety and a safe environment for clients and co-workers
• Demonstrates knowledge of safety/infection control practices by compliance with policies and procedures and regulatory requirements
• Assesses safety of environment and takes the initiative to help prevent accidents and promote safety
• Recognizes and responds appropriately to potentially unsafe situations
• Responsible for completing all mandatory and regulatory training programs
• Perform other duties as assigned

Preferred Qualifications

• Intuitive/Open minded: Must be able to see opportunities, develop and implement creative solutions to complex problems
• Achievement Drive/Commitment: Driven to achieve goals, objectives, and results. Fosters a culture of continuous improvement
• Positive/Supportive: Inspires and shows faith in others, builds a positive and supportive work environment
• Flexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure