RN-Case Manager, Home Health
Company: SSM Health
Posted on: May 16, 2022
Sign-on Bonus Available!At SSM Health at Home, we offer a range
of services all with one goal: to keep our patients as safe and
independent as possible at home.We are seeking an RN Case Manager
who is flexible, autonomous and a self-starter with strong
assessment, problem solving and computer skills. In this position
you will travel to patient homes and provide skilled nursing care
to home care patients and to coordinate the patient's plan of care
for all disciplines and services under the direction of the
supervisor and physician.This full-time position will work
Monday-Friday, 8:00 AM - 4:30 PM, including weekday on-call and
weekend and holiday rotation.Coordinates patients interdisciplinary
plan of care through assessment and evaluation of patient condition
and effectiveness of care under the direction of the attending
physician by traveling to patient homes, Community-Based
Residential Facilities (CBRF), assisted living locations, hospitals
or other to meet patient and family/caregivers, assess patient care
needs, acuity in relation to regulations of home care and/or
hospice services.PRIMARY RESPONSIBILITIES
- Collaborates with the patient, family and healthcare team to
develop a comprehensive plan of care based on the unique needs of
the patient. Responds to calls from patients, family members and
others, completes follow-up to address needs, issues, or
- Provide skilled nursing care within the established plan of
care, including performance of tasks such as taking vitals,
performing wound care, IV care, ostomy care, blood draws,
injections, and the physical assessment of the overall patient s
medical condition. Conducts patient admissions and routine
- Continually evaluates the patient s condition and the
effectiveness of treatments, plan of care, medications, and
therapies. Reviews, sets-up, and administers medications as
necessary per the established plan of care.
- Documents visit notes, treatments, and care. Follows visit
pattern according to physicians orders and ensures required visits
are completed in a timely manner. Ensures all documentation is
timely, accurate and complete in adherence to regulations.
- Collaborates, consults and communicates with physician
regarding the plan of care and changes to patient status. Provides
physician with regular updates on progress and recommends revision
of plan care, documents status and communication in adherence with
- Coordinates and communication with multi-disciplinary team
members and outside agencies as appropriate to achieve expected
outcomes for patient care and education through end of life or
discharge, ensuring accurate and complete documentation and
coordination of unique care plan.
- Provide instruction and direction to other nursing staff
regarding patients. Monitors and reviews the provision of care
provided, communicates concerns to supervisor. Provides instruction
and training as necessary. Reviews documentation to ensure
compliance to the plan of care.
- 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
- One year experiencePHYSICAL REQUIREMENTS
- Frequent lifting/carrying and pushing/pulling objects weighing
- 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
- Frequent use of hearing and speech to share information through
oral communication. Ability to hear alarms, malfunctioning
- Frequent keyboard use/data entry.
- Occasional bending, stooping, kneeling, squatting, twisting and
- Occasional lifting/carrying and pushing/pulling objects
weighing 25-50 lbs.
- Rare climbing.
- Frequent Driving. Associated topics: ambulatory, ccu, coronary,
domiciliary, infusion, intensive, maternal, neonatal, nurse rn,
Keywords: SSM Health, Madison , RN-Case Manager, Home Health, Healthcare , Columbus, Wisconsin
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