As a home health nurse with Amedisys, you will provide one on one skilled nursing care and treatment to patients in their home using a comprehensive and patient specific care plan, innovative solutions, and a preferred technology for point of care documentation. You will have the opportunity to spend quality time with the patient, in their own home, to promote their health and independence. You will have autonomy in addition to the support and collaboration of a full team of healthcare professionals.
1. Demonstrates knowledge of home care and competency in discipline specific patient care skills, required by the care center for the provision of patient care.
2. Performs patient comprehensive assessments and collaborates with patient multi-disciplinary care team (PT, OT, ST, MSW, and paraprofessionals) and other health care professionals to develop/modify and implement an individualized patient plan of care as per physician orders that ensures quality, proper discharge planning and achieves desired outcomes and goals.
3. Implements appropriate nursing clinical programs and initiatives to achieve desired outcomes.
4. Provides clinical episode management according to Amedisys' processes including oversight of patient's individualized plan of care and care plan changes as deemed necessary by patient's status or physician's ordered care.
5. Utilizes a combination of agency resources and nationally recognized standards of practice to deliver high quality care and achieve excellent patient specific outcomes.
6. Makes referrals to other disciplines as indicated by the patient's identified needs or documents rationale for not doing so.
7. Promotes and maintains patient health and independence through teaching and appropriate rehabilitative measures, assisting patients in learning appropriate self-care techniques. Advocates and ensures patient participation in care planning and goals of care.
8. Supervises caseload including LPN's and Home Health Aides. Facilitates care coordination with PRN staff when care is provided for caseload.
9. Completes documentation timely, accurately, and at the point of care, according to industry standards, conventions and guidelines, including OASIS assessments, SOC/Admissions, Recertifications, ABNs, subsequent visits, physician orders, care coordination etc.
10. Helps to achieve and maintain continuity of patient care by communicating information (for example, changes in plan of care, new orders, lab results, etc.) timely, effectively and systematically with all team members providing care for the patient including PT, OT, ST, MSW, paraprofessionals, physicians, family members and community resources. Facilitates interdisciplinary communication and follow up through care coordination on assigned caseload for duration that patients are on service.
11. Participates in Team/Case Conferences. Leads discussion on multidisciplinary cases as appropriate.
12. Maintains ongoing communication with clinical manager regarding progress of patients for assigned caseload.
13. Remains knowledgeable of organization's quality improvement programs, participates in agency performance improvement initiatives and incorporates into patient care planning as appropriate.
14. Demonstrates competency in skills for required patient care. Initiates, plans and provides staff education, and performs competency and skills validation for care team staff, such as LPN's, HHA's and RN visit staff.
15. Utilizes a combination of care center resources and recognizes standards of practice to achieve positive clinical and training outcomes.
16. Utilizes accepted Amedisys teaching materials for clinician and patient/family education.
17. Performs on-call responsibilities and on-call services to patients/families as assigned.
18. Monitors assigned cases to ensure compliance with requirements of third-party payers.
19. Protects, honors, and respects patient and co-worker confidentiality and right to privacy.
20. Stays informed of industry knowledge and nursing best practice standards.
RN Case Manager June 2019
21. Participates in clinical development and continuing education programs.
22. Performs other duties, as assigned.
* Current and unencumbered license to practice as a Registered Nurse specific to that state the employee is assigned to work for the company.
a. Nurse Licensure Compact (NLC) documents the following: The mutual recognition model of nurse licensure allows a nurse to have one license (in his or her state of residency) and to practice in other states (both physical and electronic), subject to each state's practice law and regulation. Nurses must legally reside in an NLC state to be eligible to have a multi-state license.
* Must be familiar with general use and functions of the computer, such as, user names, password concepts, internet, email, navigation of computer desktop, including starting programs, using files, and windows, effective use of navigation buttons and tool bars, ability to self-manage online HR services and online training programs. * Reliable transportation and agency required liability insurance. * Valid Driver's License. * Demonstrates knowledge of Federal/State rules and regulations, ACHC standards, and other regulatory requirements. * Demonstrated knowledge of the appropriate skills for communicating with individuals of all ages. Excellent interpersonal skills including verbal and written communication skills. * One (1 ) year of clinical experience as a Registered Nurse (RN). If < 1 year clinical experience as a RN, candidate must be approved by VP Clinical. * Current CPR certification.
Associated topics: business development, case management, development, development manager, liaison, manage, office manager, project development, project management, resource development
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.