Alternate Solutions Health Network

RN (Registered Nurse) Case Manager

Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.               

SCHEDULE: Mon-Fri, 8am-5pm. On call 2 weekend shifts, 3 weekday shifts per month. One winter, one summer holiday on call. Paid holidays


AGENCY: Beaumont Home Health

COVERED TERRITORY: Troy, Royal Oak, Madison Heights, Clawson, Berkley.


SUMMARY:

The Registered Nurse Case Manager (RNCM) assumes ultimate accountability and leadership for the assessment of the patient condition and plan of care. The RNCM provides case management, clinical care and is responsible for coordination all disciplines involved in providing quality, cost-effective and billable care through direct care and supervision of care under the direction of the physician. The RN educates patients and their family members and ensures the safety of the patient. The RN is accountable for completing accurate documentation and remains compliant with all legal rules and regulations. The RN is responsible for all practices and duties within the scope of practice as outlined by the state.


KEY RESPONSIBILITIES

  • Oversees the overall care of the patient from beginning to end of episode
  • Updates all doctor orders in patient chart accordingly
  • Notifies doctor of any significant changes of the patient’s condition
  • Manages multi-disciplinary care as applicable
  • Provides skilled nursing care in a patient’s home as ordered by the attending physician
  • Observes and monitors patient conditions
  • Performs OASIS assessments to develop an individualized plan of care and makes adjustments as needs change
  • Administers medication as prescribed by the physician
  • Helps decrease re-hospitalizations by front loading visits for high risk patients
  • Promotes continuity of care with appropriate admissions, transfers and discharges
  • Counsels patient and family on the disease/injury processes and how to manage
  • Incorporates patient and family in development of plan of care
  • Helps decrease re-hospitalizations by teaching the patient on preventative measures and making good decisions
  • Listens to patient and family members
  • Oversees and supervises total care of patient provided by nurse aides and LPNs
  • Evaluates the treatments and medical condition of the patient according to the plan of care
  • Determines if the level of care being provided meets the patients’ needs
  • Communicates with the LPNs and nurse aides on supervisory visit results
  • Completes all clinical documentation in accordance with agency protocol and Medicare/Federal guidelines
  • Documents all aspects of treatment, assessments, and patient education
  • Maintains active RN license
  • Communicates with scheduler any changes outside the normal
  • Participates in all on-call requirements and case conferences
  • Attends in-service trainings and mandatory agency meetings
  • Drives to patient’s primary location per scheduled visit.
  • Daily attendance at assigned visit locations.
  • Documents all aspects of subsequent, discharge, eval/recert/resumption of care visits within 24 hours of visits.
  • Documents all aspects of start of care visits within 24 hours of visits.
  • Completes and submits all required documentation within specified company requirements.
  • Follows plan of care as permitted within the scope of practice for a Registered Nurse.
  • Fulfills RN visits in assigned geographic location per patient need within federal and state specifications.
  • Other duties as assigned.

QUALIFICATIONS

  • Minimum of one year of experience as an RN in an acute care setting. Home care experience is desired.
  • Ability to effectively communicate and create positive impressions with patients, families, physicians and co-workers.
  • Ability to remain calm, have patience and be accommodating. Compassionate and caring while working with patients.
  • Knowledgeable on nursing best practices.
  • Ability to make appropriate nursing judgments.
  • Ability to identify a situation and handle it with the best possible solution.
  • Detail-oriented and observant.
  • Disciplined style of work ethic with the ability to prioritize and be timely
  • Ability to follow directions and work as a team member.
  • Valid driver’s license and auto insurance with your name as a listed driver.

EDUCATION AND CREDENTIALS

  • Registered Nurse with current license in the state of employment.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without reasonable accommodations.


Knowledge

Reading, Speaking, Writing English - Constantly 66%-100%

Communications Skills - Constantly 66%-100%

Computers / PDA - Constantly 66%-100%


Physical

Walking - Frequently 34%-66%

Bending - Occasionally 2%-33%

Standing - Occasionally 2%-33%

Sitting - Frequently 34%-66%

Driving - Frequently 34%-66%

Lifting up to 50 lbs. with or without assistance - Occasionally 2%-33%

Stretching/Reaching - Occasionally 2%-33%

Climbing - Occasionally 2%-33%

Hand/finger dexterity - Constantly 66%-100%

Stooping (bend at waist) - Occasionally 2%-33%


Sensory Activities

Distinguish smell/temperature - Occasionally 2%-33%

Hearing/Seeing - Constantly 66%-100%

Talking in person - Constantly 66%-100%

Talking on the telephone - Frequently 34%-66%

Hearing in person - Constantly 66%-100%

Hearing on the telephone - Frequently 34%-66%

Vision for close work - Constantly 66%-100%


Other Sensory Activities

N/A

We’ll help you put your passion for patient care to work.  Apply today!

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

We are an Equal Opportunity Employer.

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

PACE Southeast Michigan

Registered Nurse Case Manager - Pontiac

SUMMARY: The Registered Nurse Case Manager (RNCM) of the PACE Southeast Michigan (PACE SEMI) utilizes a systematic approach to nursing practice which incorporates all aspects of the nursing process including, assessment, planning, implementation and evaluation of frail elders with complex needs. The RN demonstrates a direct relationship between nursing interventions and participant outcomes, demonstrates clinical competence and engages in effective patient teaching in areas of prevention as well as treatment. The RN effectively leads or directs licensed and non-professional nursing staff in the coordinated delivery of care to participants of the PACE Southeast Michigan program. The focus of care is one that enhances functional capacity, encouraging autonomy in all aspects of care, and assures coordination of all nursing care. SPECIFIC DUTIES AND FUNCTIONS: The RNCM assesses participants’ needs and plans for appropriate nursing care upon the Initial Intake Assessment as well as upon routine Re-Evaluation Assessments. The RNCM works and collaborates with the participant and the family, as well as all members of the multidisciplinary Team in developing the participant’s plan of care. The RNCM maximizes the participant’s functional capacity by encouraging autonomy in all aspects of care. The RNCM teaches, supervises and counsels the participant, or caregiver regarding nursing care needs and other related problems. The RN utilizes adult learning principles when planning for and implementing educational information to the participants, caregivers or family members. The RNCM initiates preventative and rehabilitative procedures or programs as appropriate for the participants’ care and safety. The RNCM administers medications and treatments, as ordered by the physician/NP, and monitors the participant’s response. The RN notifies the appropriate medical personnel of changes in the participant’s status. The RNCM demonstrates knowledge of the medications he/she administers and instructs the participant/family in safe administration of medication in the home. Assesses for and encourages compliance with medication regimen. The RNCM recognizes and understands the significance of abnormal test results and utilizes critical thinking skills when gathering participant data, planning for, and implementing care. The RNCM provides safe total patient care to participants with complex health problems with a focus on the individual participant and the family. The RNCM maintains all standards of nursing practice and follows hospital policies/procedures for care delivery and medication administration. The RNCM leads and monitors licensed and other professional and non-professional staff in the delivery of nursing care to the participant in the home. The RN is responsible for monthly supervision and subsequent documentation of home health aide services provided in the participant’s home. The RNCM evaluates participant outcomes and or progress toward achieving the objectives/goals of the care plan and communicates this information among other members of the Multidisciplinary Team. The RNCM collaborates with the Interdisciplinary Team to revise the plan of care based on changes in the participants’ physical or psychosocial status, and initiates actions that are consistent with the changes in status. The RNCM participates with patients, families and members of the Interdisciplinary Team to evaluate/measure the individual and group response to nursing care and teaching interventions and documents the outcomes of the problems identified at every scheduled review. The RNCM maintains accurate and timely records of participant’s functional /health status, progress toward care plan outcomes, revisions to care plans, care given, etc. All charting and documentation is performed in accordance with CSI policies/procedures. The RNCM participates in the collection and documentation of Data PACE information. The RNCM advocates to others on behalf of the participant, and demonstrates accountability in resolving participant concerns or issues. The RNCM understands, complies with and promotes the Participant Bill of Rights and assesses and works toward achieving high levels of participant satisfaction. The RNCM may provide after hours on-call medical assistance on a rotating basis, via phone triage or after hours home visits to participants as needed. Schedule requires a rotating on call shift. KNOWLEDGE, SKILLS AND ABILITIES: Must be a Registered Nurse with current Michigan licensure, BSN preferred. The RNCM participates in annual, mandatory in-service training and screening, including but not limited to: infection control, TB testing, safety training, and BLS training. The RNCM assumes responsibility for self-development through continuing education, utilizing resources within the health care system or elsewhere; the RN promotes professional behavior and growth by serving as a role model within the health team. The RNCM must possess a current State of Michigan driver’s license and maintain an acceptable driving record. The RNCM has the ability to establish and maintain interpersonal and interdepartmental relationships. The RNCM has the ability to apply principles of adult learning in planning and implementing educational activities. The RNCM has the ability to lead and direct other licensed and non-professional nursing staff in the delivery of care. The RNCM participates in and/or facilitates Quality Assurance projects resulting from data results. The RNCM assists with the implementation of nursing research studies. The RNCM reviews current periodical literature relevant to the general practice of nursing as well as information pertaining to the PACE model of care. The RNCM ensures adherence to departmental and external standards in the provision of quality focused care by attendance at professional meetings/committees and review of national standards of practice. Must meet a standardized set of competencies (approved by CMS) before working independently. Must have one (1) year of experience with a frail or elderly population. WORKING CONDITIONS: Works in the participant’s home which is an uncontrolled environment. May be exposed to potentially infectious materials, blood-borne disease pathogens, and hazardous waste. Must be medically cleared for communicable diseases and have all immunizations up-to-date before engaging in direct participant contact Driving is required within PACE SEMI catchment area, with possible exposure to extreme temperatures, including heat and cold. Must have reliable transportation available on a daily basis. Frequent walking, bending, lifting of forty (40) pounds or more may be needed in the performance of duties.
AccentCare, Inc.

Registered Nurse / RN, Home Health

$86,000 - $96,000 / year
Overview Position Type: Full-Time Coverage Area: East Detroit, Macomb and Oakland County, MI Pay: $86,000-$96,000 This position is paid on a per-point basis. The compensation reflected in this posting is an estimate of annual compensation. Schedule: M-F 8:30am-5pm On Call: Yes What You Need to Know This RN Case Manager is responsible for managing patients' care plans from admission through discharge and for ensuring the delivery of quality patient care. The position combines direct and indirect patient care activities and directs staff nurses, LPNs, and CHHAs in delivering the individual patient’s plan of care, as well as identifying interdisciplinary needs and coordinating allied health clinicians. RN Case Manager Qualifications Graduate from an approved school of professional nursing and currently licensed to practice as a registered nurse in the state of agency operation A minimum of one year of experience as an RN Current CPR Certification required RN Case Manager Responsibilities: Assessment of the status of nursing needs of assigned patients and overall management of the patient’s care plan Complete initial patient assessment upon admission, including appropriate patient history Selects appropriate nursing diagnosis Assesses all medicines to identify possible ineffective drug therapy or adverse reactions, significant side effects, drug allergies, and contraindicated medications Establishes realistic, measurable, observable goals consistent with the patient’s diagnosis Informs the physician of the results of the assessment and recommended clinical interventions Implements appropriate nursing interventions consistent with the patient's diagnosis and established goals and within the scope of the Nurse Practice Act Re-evaluates patients' nursing and other clinical needs as required Documents and submits the assessment, progress, and discharge notes and other required paperwork in a timely fashion as required by the agency Informs the physician and other personnel of changes in the patient's condition and needs Our Investment in You Caring for others starts with caring for you. We’re committed to fostering a purpose-driven workplace where you feel supported, and that means prioritizing your physical, financial, and mental well-being. Our benefits include: Medical, dental, and vision coverage Paid time off and paid holidays 401(k) Flexible spending and health savings accounts Wellness offers, including an employee assistance program, pet insurance, and access to Calm, a meditation, sleep, and relaxation app Company store credit for your first AccentCare-branded scrubs for patient-facing employees And more! Why AccentCare? Come As You Are At AccentCare, you’re part of a community that cares — for patients and each other. You can rest assured we offer equal employment opportunities regardless of race, ethnicity, sex, sexual orientation, gender identity, religion, national origin, age or disability.
Freedom At Home

Registered Nurse (RN)

$55 - $65 / hour
Registered Nurse (RN) – Home Health Full-Time | Part-Time | PRN Excellent Pay + Paid Mileage + Flexible Scheduling Freedom at Home is a Veteran-Owned Home Health Agency and we're looking for compassionate, motivated Registered Nurses (RNs) to join our growing team. If you're looking for a company that values its clinicians, promotes work-life balance, and provides the support you need to deliver exceptional patient care—we'd love to meet you. What We Offer Competitive pay Full-Time, Part-Time, and PRN opportunities Paid mileage Flexible scheduling Supportive leadership team Positive, clinician-focused culture Opportunities for growth as we expand The chance to make a meaningful difference in patients' lives every day Responsibilities Perform skilled nursing visits, assessments, admissions, recertifications, resumptions of care, and discharges in patients' homes. Develop, implement, and update individualized Plans of Care. Complete OASIS assessments and clinical documentation accurately and on time. Monitor patient progress and communicate changes with physicians and the interdisciplinary team. Educate patients and caregivers on disease management, medications, treatments, and safety. Coordinate care with physicians, therapists, home health aides, and other healthcare professionals. Supervise Home Health Aides in accordance with state and federal regulations. Promote safe, compassionate, high-quality patient care while helping patients remain safely at home. Qualifications Graduate of an accredited Registered Nursing (RN) program. Current, unrestricted Ohio Registered Nurse license. Current CPR certification. Minimum of one year of nursing experience required. Home Health experience is preferred but not required. OASIS experience is a plus. Valid driver's license, reliable transportation, and auto insurance. Why Freedom at Home? At Freedom at Home, our clinicians are our greatest asset. We believe in treating our employees with the same compassion and respect they provide to our patients. We foster a culture built on teamwork, integrity, clinical excellence, and mutual respect. If you're passionate about providing exceptional patient care and want to work for an agency that puts both its patients and clinicians first, we'd love to have you on our team. Apply today and become part of the Freedom at Home family!
Freedom At Home

Home Health RN Case Manager

$55 - $65 / hour
Registered Nurse (RN) – Home Health Full-Time | Part-Time | PRN Excellent Pay + Paid Mileage + Flexible Scheduling Freedom at Home is a Veteran-Owned Home Health Agency and we're looking for compassionate, motivated Registered Nurses (RNs) to join our growing team. If you're looking for a company that values its clinicians, promotes work-life balance, and provides the support you need to deliver exceptional patient care—we'd love to meet you. What We Offer Competitive pay Full-Time, Part-Time, and PRN opportunities Paid mileage Flexible scheduling Supportive leadership team Positive, clinician-focused culture Opportunities for growth as we expand The chance to make a meaningful difference in patients' lives every day Responsibilities Perform skilled nursing visits, assessments, admissions, recertifications, resumptions of care, and discharges in patients' homes. Develop, implement, and update individualized Plans of Care. Complete OASIS assessments and clinical documentation accurately and on time. Monitor patient progress and communicate changes with physicians and the interdisciplinary team. Educate patients and caregivers on disease management, medications, treatments, and safety. Coordinate care with physicians, therapists, home health aides, and other healthcare professionals. Supervise Home Health Aides in accordance with state and federal regulations. Promote safe, compassionate, high-quality patient care while helping patients remain safely at home. Qualifications Graduate of an accredited Registered Nursing (RN) program. Current, unrestricted Ohio Registered Nurse license. Current CPR certification. Minimum of one year of nursing experience required. Home Health experience is preferred but not required. OASIS experience is a plus. Valid driver's license, reliable transportation, and auto insurance. Why Freedom at Home? At Freedom at Home, our clinicians are our greatest asset. We believe in treating our employees with the same compassion and respect they provide to our patients. We foster a culture built on teamwork, integrity, clinical excellence, and mutual respect. If you're passionate about providing exceptional patient care and want to work for an agency that puts both its patients and clinicians first, we'd love to have you on our team. Apply today and become part of the Freedom at Home family!
Freedom At Home

Home Health RN Case Manager

Home Health Registered (RN) - Per Diem *Fantastic pay based on points per visit type in addition to paid mileage!!! Freedom at Home is a Combat and Service Disabled Veteran owned and operated Small Business that offers Skilled Home Care Services. Welcome to Freedom at Home! Freedom at home is looking to hire compassionate, dedicated, and hard working clinicians. Clinicians who value their work and take pride in what they do. Clinicians who want to work for a company that values them and their input. Caring for patients is more than just a job to us and we want clinicians who feel the same way. We are looking to be change agents in this industry. We will strive to be a 5 star agency and maintain that. We hold ourselves to the highest standard and we welcome anyone to join our team who does the same. Clinicians on our team are highly valued and highly rewarded. We work as a team to provide the highest quality of care and outcomes. Are you a 5 star clinician? Are you tired of being under paid and under valued? Are you frustrated with working with others who don't value work ethic, compassion, respect, and dignity? Do you think healthcare can do better? If so then you may be a great fit for our Freedom team! JOB SUMMARY A professional who provides professional nursing services within the scope of nursing practice standards in collaboration with primary care physicians, teaches and educates patients and their families. Professional skilled nursing is performed under the supervision of the Administrator/Director of Nursing. QUALIFICATIONS Graduate of an approved professional nursing program (RN) Currently, licensed “in good standing” in MI Minimum of one (1) year of experience as a professional nurse, preferably in home care. Must have a criminal background check. Must have current CPR certification. RESPONSIBILITIES/ESSENTIAL FUNCTIONS Furnishes those services requiring substantial and specialized nursing skill. Initiates appropriate preventative and rehab nursing procedures. Prepares & submits timely, clinical and progress notes. Oversees coordination of patient services. Informs MD and other staff of changes in PT situation or needs. Completes medical history/home safety check/environmental assessments. Performs socio-psychological evaluation. Performs assessment visit and documents timely. (ie. OASIS/ Skilled Nursing Note etc.). Performs physical examination and review of all body systems and documents accordingly. Develops individualized Plan of Care (POC) to be submitted to the physician for approval and implementation and performs necessary revisions based upon patient needs. Determines medical necessity for other services. Regularly re-evaluates the patient’s nursing needs. Evaluates the patient’s ADL and iADL abilities and need for home health aide. Develops and implements the HHA plan of care when HHA services are ordered. Revises and signs this care plan the beginning of each certification period. Supervises HHA in accordance with state/federal requirements and documents the supervision. Orders “other” professional services that may be appropriate to the needs. Reviews billing processes with patient and/or family advising patient and/or family when co-pay or Medicare is not likely to pay for services. Effectively communicates ongoing with patient and family progression/changes in POC. Effectively communicates with Supervisor/Nursing Director/other disciplines in the case. Communication with the patient’s MD (verbally and/or in writing) to obtain effective treatment modalities and/or rehabilitative therapy modalities. Actively communicates in the case conferencing sessions to establish best practices. Submits requests for re-authorization of “more visits needed” to payers timely. Coordinates Community Services for the patient to assist in safe home care needs. Participates in the Performance Improvement Committee process. Performs timely clinical record reviews (CRR) per Agency policy in collaboration with the Nursing Supervisor. Participates in ongoing staff meetings/in-services. Participates in the growth of office by being a willing preceptor for same discipline employees. Participates in the planning, operation and evaluation of the nursing services of the organization. Maintains professional licensure per state requirements. Notifies the Agency of emergencies, sickness, and other imminent occurrences that may affect the patient caseload as quickly as possible relative to the event’s occurrence. Submits written time requests 2 weeks or more in advance of planned time off. Other duties as assigned. SPECIAL EQUIPMENT TO BE OPERATED Vehicle to do routine patient visits, possible transfer/lifting devices, medical supplies WORK ENVIRONMENT Indoors, performing patient care assessment/tasks in the patient’s residence Travel to patient residences/meetings; will require transportation to get to various work sites Possible exposure to communicable diseases FUNCTIONAL ABILITIES Able to access patient’s homes that may not be handicap accessible. Able to hear, speak, understand and communicate effectively in English. PHYSICAL REQUIREMENTS On a daily basis: walking, standing, sitting, reaching, use of telephone, use of computers & other office equipment, lifting/transferring 150 lbs or greater, bending, stooping, climbing stairs.