We are looking for a Case Manager to join our Jacksonville Branch team. If you are interested in an exiting career where no day is ever the same and you go home everyday with the satisfaction of having helped a person in need, call me, Kourtney Johnston (904) 730-9580.
Minimum Job Requirements:
- Valid FL RN license required.
- Minimum 1 year Home Health Case management experience
- Pediatric experience preferred.
- Able to problem-solve all types of issues
- Experience with Performance Improvement
- Ability to work independently and interact with personnel from entry level to executive management
- Attention to detail
- Knowledge of managed care, government payers and third party reimbursement payer requirements
- Ability to work in a team, build consensus, influence others outside a direct reporting relationship, and handle conflicts tactfully
- General knowledge of healthcare revenue cycle including familiarity with reimbursements
- Clear understanding of compliance issues, the importance of compliance and consequences of noncompliance
- Strong organizational skills including priority setting, planning, and effective decision making
- Excellent communication skills and team player a must
- Motivated and self-directed with a high degree of professional accountability
ESSENTIAL JOB DUTIES:
- Provide initial and on-going assessment of client needs using the OASIS data elements incorporated into the Comprehensive Assessment.
- Regularly re-evaluates the patient’s nursing needs
- Furnishes services requiring substantial and specialized nursing skill.
- Initiates appropriate preventive and rehabilitative nursing procedures.
- With input from patient/caregiver and in conjunction with physician, formulates and implements plan of care, evaluate effectiveness of care plan and make necessary adjustments.
- Review clinical and progress notes, coordination of services.
- Provides for the emotional and physical comfort and safety of client taking into consideration their rights and cultural background.
- Receives, transcribes, and verifies physician orders.
- Notifies physician and all Agency staff involved in patient care of changes in status or needs.
- Participates in case conferences, team meetings, staff meetings and Performance Improvement activities
- Supervises and teaches other skilled and non-skilled personnel; evaluates performance and knowledge of the nursing process
- Occasional on-call and after hours duties as necessary to meet the needs of the client
- Counsels family and patient in meeting nursing and related needs.
- Provide supervision for licensed practical nurse, home health aide, and/or certified nursing assistant.
- Provide monthly summary of skilled services and client outcomes to physician and Agency Supervisor in keeping with Agency policies and procedures.
- Gathers supporting documentation for the authorization process
- Adheres to all Agency policies and procedures including but not limited to the HIPAA Privacy rule.
- Ensures standards of case management practices and integrated services are developed, implemented and monitored for consistency with professional standards and regulatory requirements
- Promote and maintain positive relations with patients and their families, as well as other healthcare organizations.
- Perform random chart reviews to ensure accurate and thorough documentation to support reimbursement of services rendered.
- Other duties as assigned by the Director of Clinical Services