Case Manager
$70,000–$85,000 year
On-sitePueblo, Colorado, United States
Pueblo, Colorado, United StatesOn-siteFull Time$70,000–$85,000 yearLarge
Full TimeLarge
Job Summary
Develop and implement individualized patient-centered care plans for assigned patients and ancillary staff under physician supervision. Conduct initial evaluations, reevaluate nursing needs, and administer medications per policy and orders. Coordinate care between patients, families, and healthcare providers while documenting clinical progress notes, OASIS data, and infection reports within required timeframes. Provide counseling on home health strategies, manage medication reconciliation, and refer cases to specialists for specialized needs. Participate in case conferences, quality assurance reviews, and in-service training programs. Maintain on-call availability for nights, weekends, and holidays to provide after-hours assessment and triage decisions.
Required Qualifications
- Qualified registered nurse
- Ability to provide and oversee the care of assigned patients and associated staff
- Ability to act in accordance with physician orders and the plan of care per state Practice Act
- Ability to report to a Director of Nursing/Director of Patient Care Services/Clinical Supervisor/Nursing Supervisor/Clinical Manager
- Ability to develop, deliver/implement, revise, and evaluate individualized patient-centered care plans
- Ability to provide case management to an assigned group of patients and ancillary staff
- Ability to understand and submit required data collection sets (OASIS, PAR, etc.) and other documentation as requested by the state and/or federal government and insurance payers within required timeframes
- Ability to make the initial evaluation visit and regularly reevaluate the patient's nursing needs per state and payor requirements
- Ability to act as an advocate for patient welfare
- Ability to coordinate care between patients, their families/caregivers and/or their authorized representative, the agency and other healthcare providers/facilities/ outside agencies
- Ability to furnish services requiring substantial specialized nursing skill according to competency level
- Ability to demonstrate problem solving abilities and positive interpersonal communication skills
- Ability to identify care preferences of patients and verify that interventions meet the patient's needs and their goals of treatment
- Ability to initiate appropriate preventive and rehabilitative nursing procedures
- Ability to prepare clinical and progress notes for each patient visit and summaries
- Ability to attend case conferences as assigned
- Ability to inform physician and other personnel of changes in the patient's condition and needs
- Ability to counsel the patient and family/significant others in meeting nursing and related needs
- Ability to educate on the proper home health strategies and procedures utilizing community resources as applicable
- Ability to observe and report patient symptoms, reaction to treatments, drugs and changes in the patient's physical or emotional condition
- Ability to be responsible for medication reconciliation
- Ability to participate in in-service programs, supervising and teaching other nursing personnel as assigned
- Ability to administer medication per agency policy and physician orders
- Ability to provide written instructions for aides or other ancillary disciplines caring for the patient
- Ability to process orders and notify physician of patient needs and changes in condition
- Ability to refer cases with physician's orders to Physical Therapist, Speech Language Pathologist, Occupational Therapist and Medical Social Worker
- Ability to understand and adhere to the Policy/Procedure, Best Practices, Infection Control Plan, EMS Plan, and the Compliance Plan
- Ability to participate in clinical record/utilization review of medical records and quality assurance and performance improvement (QAPI) quarterly and as assigned
- Ability to report/record all applicable infections, occurrences, and complaints
- Ability to submit documentation within 24 hours or per state requirements
- Ability to maintain confidentiality of patient, employee, and agency matters
- Ability to take on-call duty nights, weekends, and holidays, as assigned
- Ability to function as the after-hours supervising nurse and make nursing assessment and triage decisions under the guidance of the overall Clinical Supervisor
- Ability to immediately report to Nursing Supervisor any patient incidents/variances or complaints
- Ability to demonstrate competent performance of technical skills according to established procedures
- Ability to maintain acceptable attendance status, per Agency policy
- Ability to report all incomplete work assignments to Nursing Supervisor
- Ability to demonstrate effective time management skills through daily documentation and infrequent overtime for routine assignments
- Ability to ensure that visit schedule with frequency of visits, complete medication profile, any treatments to be administered by agency staff (POC), any other pertinent instruction related to the patient's care needs, name and contact information of the agency's Clinical Manager is given in writing to the patient/caregiver/representative
- Average computer skills with competency in media communications
- Physical abilities to perform the described duties
- Ability to organize work procedures through time management, assume responsibility and effectively supervise ancillary disciplines per state requirements
- Ability to secure transportation and travel as required
- Ability to apply professional training to critically think through patient needs, follow physician's orders and produce accurate records of nursing activity within agency guidelines
- Acceptance of philosophy and goals of this Agency
- Ability to exercise initiative and independent judgment
- Ability to meet all health requirements for clearances and for current CPR
- Ability to maintain licensure and continuing education as applicable
- Graduate of an approved school of professional nursing
- Currently licensed in the state(s) in which practicing
- One (1) year nursing experience
- Home care experience
Desired Qualifications
- One (1) year nursing experience and home care (preferred)
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