Registered Nurse Case Manager

About This Role

Registered Nurse Case Managers are responsible for managing caseloads of patients in specialty areas, conducting initial assessments, and establishing comprehensive plans of care. This role involves direct patient care, ongoing assessment, and collaboration with physicians and other healthcare team members to ensure continuity of care and facilitate discharge planning.

Responsibilities

• Assume responsibility for caseloads consisting of patients in specialty areas
• Conduct initial assessment to obtain thorough physical, social and environmental data
• Establish the plan of care in accordance with physician orders and patient needs
• Provide direct patient care and adjust nursing care processes as needed
• Identify problems, modify nursing care plan, and evaluate outcomes within an appropriate time frame
• Advise and consult with family and other personnel, as appropriate
• Provide on-going assessment of patient response to treatments and teaching and apply interventions as appropriate
• Update and revise plan of care as indicated
• Complete documentation including visit assessment, OASIS, 485 and verbal orders accurately and promptly and within the standards
• Communicate with physicians to confirm and update patients' plan of care
• Provide status updates and ensure ongoing communication with the physician and other members of the health care team
• Facilitate the discharge planning process according to standards and utilize resources to assure continuity of care after discharge
• Participate in developing the discharge plan with the patient/family, physician, social worker, and other staff members as appropriate
• Participate in chart audits and continuous quality improvement activities as requested
• Identify, develop and participate in process improvement opportunities that will enhance the quality of the services provided
• Maintain and update accurate clinical and patient records according to agency, state, and federal guidelines
• Demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served
• Demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures

Requirements

• Registered Nurse license issued by the state in which the team member practices
• Basic Life Support (BLS) for Healthcare Providers certification issued by the American Heart Association (AHA) needs to be obtained within 6 months unless department leader has determined it is not required