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RN-Case Manager, Home Health

Company: SSM Health
Location: Madison
Posted on: January 14, 2021

Job Description:


  • Ensures compliance with Condition of Participation (CoP) discharge planning.
  • Identifies and escalates gaps/barriers related to inpatient and observation length of stay.
  • Assesses patients at high risk for readmission. Identifies root cause for readmission. Develops plan and collaborates with multidisciplinary team regarding discharge planning to next level of care.
  • Participates with other members of team regarding opportunities for improvement in standard work.
  • May also be responsible for: utilization management process, ED case management process, admission process, and act as a case manager liaison with post acute providers (skilled nursing facilities, rehab, home health, etc.).
  • Applies the existing body of evidence-based practice and scientific knowledge in health care to nursing practice, ensuring that nursing care is delivered based on patient's age-specific needs and clinical needs as described in the department's Scope of Service.
  • As an SSM Health nurse, I will demonstrate the professional nursing standards defined in the professional practice model. Uses the ANA Code of Ethics for Nurses to guide his/her response to the current and evolving health and nursing needs of our patients and our patient populations.
  • Works in a constant state of alertness and safe manner.
  • Performs other duties as assigned.EDUCATION
    • Graduate of accredited school of nursingEXPERIENCE
      • Three years' acute care experiencePHYSICAL REQUIREMENTS
        • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
        • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
        • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
        • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
        • Frequent keyboard use/data entry.
        • Occasional bending, stooping, kneeling, squatting, twisting and gripping.
        • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
        • Rare climbing.

Keywords: SSM Health, Madison , RN-Case Manager, Home Health, Executive , Madison, Wisconsin

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