Home Care Admission RN/Case manager

Touchette Regional Hospital in Centreville, IL

  • Industry: Healthcare - Nursing - Others
  • Type: Full Time
position filled
Home Care Admission RN/Case manager Department:Southern Illinois Home Care Schedule:1st Shift:FT Hours:80 Job Details: + Bachelors Degree + RN Required + 3-5 years of experience preferred + Touchette Regional Hospital offers a competitive sign-on bonus for all RN and LPN positions, as well as a competitive referral bonus for all current employees that refer a new RN or LPN to the hospital. To ensure that the current employee who referred you receives credit for the referral, please enter their name in the "referral" section of the application - please include their first name, last name and department, if you know the department in which they work. Position Summary: Under the direction of the Clinical Nurse Manager - coordinates all referrals, completes necessary screening of referrals, submits insurance authorizations and completes updates, assigns assessments, and assists with hospital discharge planning of Southern Illinois Home Care (SIHC) clients. Coordinates interdisciplinary care provided to patients as prescribed by the physician and/or the patients and their families. Assists clinical and operations manager with quality indicators, tracking and analysis. Home Care Admission RN / Case Manager is a professional who has the responsibility/accountability for managing daily home care admissions and initial case management of patients in accordance with the mission, vision, values, goals and performance standards for the organization. Position Qualifications: Graduate of an accredited nursing school/program with a Bachelor's degree in Nursing. Current licensure as a registered Nurse in the State of Illinois. Computer literate. Computer literacy content focuses on computer basics and the use of generic software applications such as word processing, presentation software, and the use of electronic communication such as email. The preferred computer applications are Microsoft Office Suite (e.g., Outlook, Word, Excel, PowerPoint & Access or other similar database program). Knowledge and use of Electronic Health Records (EHR). Minimum of 3 years' Home Care experience and 2 years' Home Care case management experience. Must have Certified Home Health Case Management Certification (CHHCM) or complete certification within 1 year of hire date. Preferred Skills and Abilities: Strong communication and interpersonal skills. Ability to use critical thinking skills and problem solve effectively. Essential Functions: Demonstrates Caring, Professionalism and Respect (cPr). Maintains an environment that preserves individual dignity and respect for privacy and confidentiality. Acknowledges and respects cultural, generational, socio-economical and educational diversities; interacts professionally. Accountable for maintaining an attitude and behavior that is in accordance with the hospital mission, vision, values, goals and performance standards. Fosters and maintains a safe workplace. Demonstrates flexibility to adapt to regulatory, organizational and departmental changes. Demonstrates an ability to prioritize, organize and perform under stressful/non-stressful situations. Conscious of the needs of others; offers assistance when necessary and provides service with a sense of compassion and empathy. Interacts appropriately with the age and development levels of internal and external customers. Sustains self-motivation for professional and personal growth. Accountable for maintaining an attitude and behavior that exhibits pride in your work and the organization. Maintains professional appearance in accordance with policy; considers the effects of appearance on customer expectations and needs of specific job environment. Assesses, develops and evaluates own goals for professional growth. Demonstrates an ability to prioritize, remain flexible, well-organized and functional under stressful situations. Maintains self-motivation and productivity utilizing effective time management skills. Ability to communicate effectively through written and verbal skills. Demonstrates knowledge of basic insurance coverage, reimbursements and benefits management. Duties and Responsibilities: Proficient on OASIS assessments/documentation, fully responsible for client assessment, care planning development, obtaining orders, initiating virtual care and communicating to care team. Answers intake phone calls, fields calls and accepts referrals. Coordinates all intake calls and screens for appropriateness. Communicates with referral source to verify orders. Receives referrals and ensures appropriate clinician and/or therapist(s) assignments for timely patient evaluation by signing off after authorization and plotting start of care (SOC) visits. Evaluates clinician and/or therapist(s) workload and assigns referral as indicated. Assists with changes in staff schedules and reassigns patients appropriately. Coordinates patient care with other services. Enters patient referral information into EHR database. Initiates patient medical record, obtains appropriate physician orders for initiation of service and any specific interventions required. Verifies insurance and coordinates authorizations with revenue cycle department and tracks approved authorizations. Confirms receipt of Face-to-Face encounter documentation and/or alerts Clinical Manager that documentation has not been received. Tracks pending patient referrals, ensuring all requirements for admission are accomplished and logged on referral log. Collects all referral documents into an admission packet and scans documents to EHR. Ensures patients' needs are continually assessed and care rendered is individualized to patient needs, appropriate and reasonable, meets Home Care eligibility criteria and is in accordance to physician orders. Oversees and assures development, implementation and updates to the individualized patient plan of care as appropriate. Assists with quality indicators, collection and analysis. Addresses and resolves customer complaints and/or concerns independently whenever possible. Implements Chain of Command when necessary. Adheres to organizational policies and procedures. Adheres to time and attendance requirements. Successfully completes organizational and departmental orientation and/or mandatory annual training, competencies and in-services. Completes annual Employee Health requirements. Demonstrates participation in organizational, office, nursing and departmental communications, which include, but are not limited to: Unit meetings, intranet and emails. Participates and promotes activities regarding quality and process improvement. Anticipates requests and accepts assistance from others. Adheres to Infection Prevention Plan and policies. Assesses and maintains department specific equipment and products. Other related duties as assigned. Responsibility/Accountability: Understands, participates and monitors Home Care quality and performance improvement processes. Responsible for quality of patient care outcomes, utilization of services/visits, evidence-based care delivery; and overall communication and collaboration towards effective advanced disease management. Working Relationships: Identifies and maintains a professional working relationship with peers, and both internal and external Routinely interacts and fosters relationships with both internal and external customers to maintain awareness of needs and satisfaction of services provided. Problem Solving/Decision Making: Identifies problems/issues which interfere with Home Care practice and consults with/reports to Clinical Manager when appropriate. Compliance/Regulations: Maintains HIPAA and confidentiality according to hospital policies and procedures. Maintains compliance of Medicare, Medicare Conditions of Participation, and State survey requirements and all regulatory agencies to include all government agencies and Joint Commission. Maintain Joint Commission readiness at all times. Complies with safety, emergency preparedness, infection control and customer relation standards. Maintains and understands OASIS data collection and reporting process. Complies with all policies and procedures of hospital. </script>

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