Full Job Description

Company Overview

The Home Health RN Patient Case Manager is responsible for the overall supervision and coordination of clinical services. Coordinates and supervises an interdisciplinary team of staff to assure the continuity of high quality care to home health patients assigned to the team's area in accordance with physician prescribed plan of care, and all applicable state and federal laws and regulations.

Thrive Health care services is the preferred post-acute care partner for hospitals, physicians and families in Northern Virginia. From home health to long-term acute care and community-based services, we deliver high-quality, cost-effective care that empowers patients to manage their health at home. Hospitals and health systems around the Northern Virginia area have partnered with Thrive Health Care Services to deliver patient-centered care in the home. More hospitals, physicians and families choose Thrive Health Care Services, because we are united by a single, shared purpose: It's all about helping people.

Essential Functions

Receives referrals and ensures appropriate clinician assignments for timely patient evaluation by signing off after authorization and plotting start of care (SOC) visits.
Coordinates determination of patient home health benefits, medical necessity, and ongoing insurance approvals.
Ensures patient needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets home health eligibility criteria, and is in accordance to physician orders.
Oversees and assures development, implementation, and updates to the individualized patient plan of care, as appropriate.
Manages and documents phone calls from physicians, clinicians, patients, referral sources, and communicates patient updates/new orders to clinicians. Uses coordination notes to document, as needed and appropriate.
Reviews assessments and plans of care daily, per assigned workflow, and consults clinicians and the DON with recommendations, as appropriate.
Coordinates all aspects of care with all disciplines, physicians, durable medical equipment providers, caregivers/family members, transferring facilities, and any other applicable healthcare providers.
Follows-up on lab and other clinical diagnostic test, physician contact, and significant changes in the patient condition to ensure adequate physician notification, follow-up, and needed plan of care modifications and communicates such to clinicians.
Schedules, prepares for, facilitates, and documents case conference/SOC reports and facilitates effective exchange of information across disciplines especially with adverse findings, changes in patient condition, daily and urgent updates, as necessary.
Assists clinicians in coordinating the transfer and discharge of patients from agency services as indicated by the physician.
Receives report from field clinicians and nurses prior to scheduled days off on patient status and ongoing needs.
Writes and processes orders when taking verbal orders directly from the physician and communicates such to field clinicians/nurses.
Assures payer change documentation is completed properly and timely, as required.
Reviews field nurse's notes weekly to ensure timely, complete, appropriate, and accurate submission of all documentation by field staff. Takes necessary action to correct adverse findings and communicates trending to clinical director.
Reviews, evaluates, and supervises service delivery to ensure appropriateness of care and utilization of services, equipment, and supplies through activities such as random patient visits, medical record reviews and case conferences.
Enters infections and incidents/occurrences into the online Risk Management Incident Reporting System, as specified by policy.
Assists in the orientation of new agency personnel.
Provides direction and leadership to clinical team members in collaboration with the clinical director.
Provides direct patient care, as necessary, in accordance to scope of practice and physician orders.
Participates in QAPI program.
Directs clinicians in utilizing best practice interventions when finalizing Plan of Care for all patients.
Participates in on-call rotation.
Follows-up with On-Call events daily.
Receives report from weekend and after-hours clinicians admitting new patients.
Completes Thrive Health Care Services required learning courses, additional assignments per Director of Nursing request, as well as any state specific required training per state regulation/practice act requirements.
All other duties as assigned.

Education & Experience

License Requirements

Current RN licensure in state of Virginia
Current CPR certification required
Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation

Job Type: Full-time

Schedule:

8 hour shift
Monday to Friday

Job Type: Full-time

Pay: $76,194.00 - $82,965.00 per year

Benefits:

401(k)
Flexible schedule
Health insurance
Mileage reimbursement
Paid time off
Referral program
Vision insurance

Medical Specialty:

Home Health

Schedule:

Monday to Friday

Education:

Associate (Preferred)

Experience:

Nursing: 1 year (Preferred)
Case management: 1 year (Preferred)

License/Certification:

RN (Preferred)

Willingness to travel:

25% (Preferred)

Work Location: In person

Thrive Health Care Services LLC

Latest Jobs

RN Case Manager Home Health