RN Case Manager - CareRing Health, LLC

We are a leading provider of home health services in Pennsylvania. Our mission is to provide exceptional
services to patients who need our help the most.

We are seeking talented, passionate individuals to join our team and help our patients live happier and healthier lives…in
their homes.

What We Offer*:

We know that, to be the best place for our patients, we must be the best place to work for our employees. We offer the
following to our employees:

• Be part of a unique healthcare company where we can help those in our communities who need our help the
most
• Flexible hours/work-life balance
• Competitive pay
• Paid on a weekly basis
• Medical/dental/vision/life insurance
• Paid holidays/PTO/401(k) match
• Career growth opportunities
• Great and collaborative work environment

• Assesses and plans client care, as needed, using age-appropriate norms and principles of growth and development.
• Identifies client needs based on comprehensive assessment.
• Delivers care following physicians’ orders, nursing standards, and Agency policies and procedures.
• Documents care according to regulatory requirements and Agency policies and procedures.
• Participates in employee recruitment and retention activities.
• Evaluates personnel performance in accordance with organizational policies; counsels or corrects as needed; reports progress to Director of Clinical Services as appropriate.
• Teaches and assists clinical staff in appropriate case management and utilization of resources and regulatory compliance.
• Conducts educational presentations for clinical staff.
• Encourages clinical staff attendance at educational and work group meetings.
• Acts as role model and mentor for clinical staff.
• Reviews OASIS information to ensure proper assessment and documentation by field staff.
• Reviews clinical staff documentation to ensure timeliness, accuracy, and completeness.
• Makes client visits and accepts on-call responsibilities, as needed.
• Conducts pre- and post-billing reviews of Medicare, Medicaid, and Commercial skilled services.
• Knows and adheres to federal, state, and other regulatory agency requirements.

CLINICAL COORDINATION:

• Provides overall coordination and case management oversight of the Agency’s clients; ensures clinical staff delivers high-quality services in an efficient and effective method.
• Assists with planning and coordinating of care delivery.
• Utilizes Plans of Care (POCs), 485s, OASIS, orders, recertifications, transfers, and discharge planning to identify client needs and assures appropriate care is provided.
• Serves as liaison between client/physician and Agency.
• Assigns field personnel as appropriate and in accordance with caseload review; monitors daily and weekly schedules, matching needs, abilities, and territories to the assignment. Communicates staff assignments and coordination of service delivery to clinical staff and scheduler.
• Assists staff with ordering of medical supplies; monitors judicious use and allocation of needed supplies.
• Assures appropriate triage of clients and planning for potential disasters.
• Monitors staff productivity and coordinates results with Director of Clinical Services to adjust assignments as appropriate.
• Oversees tracking of clinical staff attendance at work, as well as mandatory in-services or meetings, addresses attendance problems.
• Supervises the implementation and outcomes of the physician’s POC.
• Collaborates with clinical staff to monitor client progress, POC revision, ancillary referral needs, and appropriate utilization of services.
• Conducts care conferences to assure interdisciplinary input to addressing client needs in order to obtain positive client outcomes, according to Agency standards.
• Directs or supervises clinical staff to assure that completion of reports and other items is supportive of Agency activities as related to Performance Improvement, Infection Control, etc.
• Performs on-site assessment visits to determine the appropriateness of documented data, including OASIS, compared to client needs and POC; documents deviations in OASIS data and addresses such deviations in Performance Improvement Performance activities.
• Ensures that new clients are contacted periodically to evaluate the quality of services being provided; monitors client satisfaction and needs; implements changes in services provided as needed.
• Participates with staff in discharge planning of clients.
• Assists with obtaining and processing referral information from multiple sources in an accurate and timely manner.
• Reviews referrals to ensure complete information; verify authorization number; clarifies and pursues additional information as needed to establish sufficient data to support the admission process.
• Oversees verification of insurance and/or authorization of care.
• Receives physician orders, processes appropriately, and communicates to clinical staff.
• Review orders and release orders daily.
• Review all OASIS and complete list to be submitted to state.
• Assists with developing and implementing appropriate process improvement plans that address issues related to Performance Improvement, Adverse Events, Case-mix, etc.

• Has graduated from an accredited school of professional nursing; holds a valid Registered Nursing license in the Pennsylvania.
• Prefer a Bachelor’s degree in nursing or related field.
• Three years of nursing experience in home health field.
• Two years of supervisory experience.
• Holds valid CPR certification.
• Demonstrates clinical competency and provision of high-quality care to clients.
• Is knowledgeable of home health regulations.
• Exhibits outstanding organization, leadership, communication, and human relations skills.
• Is self-motivated, assertive, and able to make independent decisions.
• Employs critical thinking skills.
• Demonstrates ability to be flexible and to fulfill a broad range of clinical supervision responsibilities.
• Is able to handle multiple priority projects.
• Is able to use computer for word processing, spreadsheet, and data entry applications