Registered Nurse RN Clinical Case Manager

Job Description

The RN Case Manager reports directly to Clinical Director and is responsible for care coordination of clinical staff and patient / family clientele. Responsible for admissions and recertification assessments, including supporting documentation, as assigned. This position ensures compliance with MGA policies, State policies and procedures, and policies of accrediting agencies, as well as responsible for maintaining compliance with all reimbursement guidelines and maintaining patient confidentiality / HIPPA guidelines. Furthermore, individual will participate in program development, implementation, as well as collaborating with Client Service Managers to acquire / develop new relationships with clientele.

Duties and Responsibilities

• Ensures supervision of all home care personnel, as assigned.
• Enforces / demonstrates compliance with State / Federal regulations.
• Ensures effective communication to coordinate the implementation of each patient’s Plan of Care.
• Instruct, train, and re-educate on clinical skills / procedures when necessary.
• Responsible for direct supervision of field LVNs / LPNs / RNs per State guidelines.
• Provides support, guidance, and education to patients / patient families and or caregivers to maintain optimal physical and emotional wellbeing.
• Communicates all occurrences and other pertinent information to the Clinical Supervisor / Director of Clinical Services.
• Ensures any observed or suspected child / adult abuse, neglect, or exploitation is reported to proper authorities as mandated as a health professional.
• Collaborates with Clinical Supervisor and Director of Clinical Services to resolve client / clinical concerns in timely manner.
• Office Responsibilities to Ensure and / or Facilitate the following :
• Develops and implements the treatment plan for each patient under the direction of physician.
• Completes all clinical documentation in timely manner, including admissions, recertification’s, resumptions of care, accurately and ensures that documentation meets all requirements per agency policies and State regulations.
• Reviews clinical documentation to ensure it is complete and reflects skilled services to meet payer source requirements for reimbursement.
• Interviews and evaluates potential clinical field staff to ensure competency in order to promote appropriate / safe patient care.
• Complies and participates in the continuing quality improvement by appropriately reporting of incidents, injuries, infection and all components of the risk management program.
• Participates in agency sponsored continuing education in-services and conferences to maintain own clinical competency.

Supports and executes the mission, ethics, and goals of the company effectively.

Qualifications : Qualifications

Additional Information

Benefits are available to eligible employees on the first of the month after 30 days of employment and include :

All your information will be kept confidential according to EEO guidelines.

#IND123-CCM