VISITING RN CASE MANAGER

HHA Field · Detroit, Michigan
Department HHA Field
Employment Type Full-Time
Minimum Experience Mid-level

Work Flow Necessary to Ensure Clinical & Financial Success (component proportion 75%), reports availability routinely, preferably weekly, to the scheduler, embraces and adheres to the use of electronic documentation via the organization’s software solution, completes assigned Work Flow tasks within time frames allotted by the Agency, responds timely to patient assignments and also responds in accordance with the Agency’s guidelines when s/he will not be able to accept assignments, performs and documents nursing service delivery related to patient admission and re certification including the OASIS data set and Plan of Care, completes data set information, as assigned, regarding patient events, (i.e. transfer to in-patient facility, death in home, resumption of care, discharge), and follow-up.


Obtains and documents physician orders, when appropriate, responsible for the submission of all documentation and receipt of physician orders to ensure timely locking of OASIS and timely submission of billing, submits nursing orders and documentation, when appropriate, reviews data regarding patient assignments including but not limited to OASIS, Plan of Care, and Coordination Notes prior to service delivery,  Submits requests for new supply requisitions when a new supply order is needed.

Responds to requests from location staff to clarify information needed for the Plan of Care (485) or OASIS.

Documents OASIS changes in the Coordination notes, when applicable.  Assists with intake of patient referrals and in the coordination of services between disciplines and other healthcare providers.  Participates in the reporting of lab results and/or abnormal findings to the appropriate healthcare professional, physician, and/or field clinician.

Provides supervision of home health aides and LVN/LPN team members, as assigned. Participates in patient case conferences and documents ongoing Coordination of Care with other members of the healthcarQAPI Activities/Home Health Compare Reports.  Reports and documents Client Complaint and Client Occurrence Events, when appropriate.

Participates in the QAPI process of the agency, seeking to identify opportunities for performance improvements

Reports significant patient findings to the RN Case Manager and the RN Clinical Team Manager and collaborates on actions or interventions to be

Reports and documents patient infections per policy. Works to maintain positive, collaborative relationships with patients, caregivers, referral sources, and/or physicians

Maintains availability at all times during his/her scheduled hours of work, either in person or by telecommunications. Maintains current knowledge of nursing practice and is responsible personal continuing education required by the governing laws of Michigan Participates in internal staff meetings and training activities, as needed Collaborates with members of the marketing team to assist in identifying potential referral sources, and patients appropriate for home Performs all other duties as requested of them per agency Policy

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  • Location
    Detroit, Michigan
  • Department
    HHA Field
  • Employment Type
    Full-Time
  • Minimum Experience
    Mid-level