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Job CategoryPatient Services
Job FamilyCare Coordination
DepartmentHome Plus RC Home Care Services
Scheduled Weekly Hours40
Job SummaryThe case manager supports patient care coordination in the home care and hospice setting. The clinical case managers primary responsibility is to be a resource for the interdisciplinary team. This will include working with physician/referral sources/insurances/families in coordinating the delivery of care in the home care and hospice setting. The case managers oversee the day to day quality of the program and collaborates with leadership to improve and monitor process to provide optimal patient care. The case manager collaborates with the interdisciplinary teams in the management of education, bio-psychosocial and financial resources to achieve optimal outcomes for home care patients. The case manager will demonstrate performance consistent with the professional standards of practice, care and the Nurse Practice Act.
- Optimize care coordination with hospital, ER, Nursing homes, Assisted living facilities, physicians and community resources as necessary. Collaborates with physicians, providers and interdisciplinary team to indentify appropriate patients for home care and hospice.
- Acts as a resource to interdisciplinary teams, patients and families throughout episode of care. Facilitates efficient, appropriate, seamless, coordinated care to help ensure positive patient outcomes.
- Quality review of data, care plans, coding, documentation, oasis, HIS is analyzed to ensure the achievement of consistent clinical/financial outcomes. Data outcomes is used to identify indicators where process improvements projects are developed.
- Works with caregivers, schedulers, physicians and administration to coordinate care based on patient needs, geographic area, caregiver skill set to meet regulatory standards. Demonstrates effective fiscal management through cost containment measures while ensuring high quality, cost effective care is being provided to patients within the home care program.
- Assists leadership in the development of program goals and objectives. Assist with the development , implemnatation and maintenance of quality programs that include best practice patient care outcomes.
- Directly or indirectly ensures 24 hour care provided 7 days per week across our service area.
- Coaches staff and assists in performing supervisory visits to ensure regulatory compliance is met. Takes a leadership role in the participation of any survey across the division. Assists leadership in action plans/audits.
- All other duties assigned.
Education - Associates degree in Nursing
Certification - Registered Nurse (RN) - South Dakota Board of Nursing; Cardiopulmonary Resuscitation (CPR) Certified - American Heart Association (AHA)
Education - Bachelors in Nursing
Experience - 3+ years of Registered Nurse Experience; 3+ years of Home Medical Equipment ExperienceMedium work - Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.40 Monument Health Home Plus
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