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The Home Health and Hospice RN Case Manager assesses, plans, implements, and evaluates patient care in order to achieve optimum patient outcomes for patients as appropriate to service area. Age specific admission and ongoing assessments are completed, documented and used to develop a plan of care. Nursing care and provision of individualized care for patients. Utilizes delegation and critical thinking skills to provide quality service through a team oriented, collaborative approach to patient care.

Sign on bonus eligible. Company equipment. Mileage reimbursement.

Responsibilities include:

• Assesses, plans, implements, and evaluates patient care in order to achieve optimum patient outcomes for patients of all ages as appropriate to service area.
• Understands Hospice concept of care and the complex issues related to caring for the terminally ill. Provides competent, compassionate care in a variety of settings.
• Age specific admission and ongoing assessments are completed, documented and used to develop a plan of care.
• Collaborates with other members of the health care team/patient/family to develop, implement, and evaluate an age-specific interdisciplinary plan of care. Revises plan according to changes in patient status.
• Administer and document treatments and medications for patients utilizing automated computer systems, including electronic medical records.
• Ensures patient care orders are current, accurate, implemented, and evaluated for effectiveness per provider order.
• Identifies patient/family (caregiver) educational needs, incorporates education into the plan of care, and documents.
• Contributes to Carilion Clinic's performance improvement activities.
• Advocates for patient, protector of patient's rights, and provider of psychological/social/cultural support.
• Plans, coordinates, and provides clinical care in a way that promotes positive patient outcomes, promotes safety during vulnerable periods of transition, and upholds a culture of patient centered care.
• Exhibits clinical expertise in rapidly changing circumstances.
• Plans strategies to prevent avoidable re-hospitalizations, reduce length of stay, turnaround time, resource consumption and improve patient outcomes.
• Seeks direction from supervisor as needed in order to affect the best possible outcome for patients served.
• Manages resources, establishes priorities, and modifies environment to meet patient care needs.
• Completes manager/director predetermined projects within specified time frame and according to pre-established guidelines.
• Facilitates resolutions for patient and work situations.
• May provide orientation to new employees.
• May supervise LPN as required per regulatory guidelines. LPN supervision will require additional caseload numbers for RN/LPN team.
• Keeps case management worksheet up to date.
• Manage case conferences on assigned patients.
• May supervise Home Health Aides and evaluations.
• Ensures visit frequencies reflects orders and are appropriate with evidence-based practice.
• Collaborates with centralized scheduling to ensure appropriate adjustments to visit frequencies are made as needed.
• Collaborates with billing to ensure pre-authorization is appropriately secured and patient financial obligations are communicated.
• Performs skilled visits including OASIS visits as needed. "Case Manager" preferably performs recertification visit. Creates new plan of care 485/486.
• Coordinates appropriate provision of BIPA and ABN forms or any others as directed by CMS or agency policy.
• Utilizes Mifi device to access information promoting quality of care and continuity. Mifi is also to be utilized to frequently transfer device to promote hand-off of communication.

Education: Graduate of accredited Registered Nurse Program.

Experience: None.

Licensure/Certifications/Registration: Currently licensed as Registered Nurse in the state of Virginia or approved compact state. Must have valid driver's license, automobile insurance, and personal vehicle for making home visits.

Other Minimum Qualifications: Keyboarding skills required for automated computer systems, including electronic medical records. Demonstrates knowledge of the principles of life span growth and development and assesses data reflective of the patient's status. Interprets the appropriate information needed to identify each patient's requirements relative to his or her age specific needs and provides care according to departmental policies and procedures. Work involves application of advanced knowledge and skills of patient care. Strong critical thinking skills are necessary and needed to interpret laws and regulations related to CHCS and Carilion Clinic. Work is performed in a patient care environment and is often fast paced, requiring use of prioritization skills. Applies knowledge of growth and development to appropriately care for patients served.

This job description is only meant to be a representative summary of the major responsibilities and accountabilities performed by the incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Compensation Range: $33.52 - $50.28

Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan.

Recruiter: Chris Fitzgerald

Recruiter Email: cdfitzgerald@carilionclinic.org

For more information, contact the HR Service Center at 1-800-599-2537.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.

For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies

Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That's why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life – at work and when you're away.

When you make your tomorrow with us, we'll enhance your potential to realize the best in yourself. Below are benefits available to you when you join Carilion:

• Comprehensive Medical, Dental, & Vision Benefits
• Employer Funded Pension Plan, vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• Onsite fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app, Personify Health
• Discounts on childcare
• Continued education and training