Remote Registered Nurse (RN) Care Manager - Home Health
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Our culture and people are what set us apart from other post‑acute care providers. We are dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.
Time: Monday‑Friday 8:15AM‑5:00PM with Holiday Rotation. Agency: Alternate Solutions Health Network. Location: Remote (Ohio).
The ideal RN will have 2 years of Home Care experience, 1 year of clinical review and 2 years of case management or utilization management experience.
Responsibilities
Develop, oversee, and maintain patient care plans.
Serve as liaison for collaboration and communication with field staff.
Participate in interdisciplinary team meetings to ensure tight collaboration and appropriate care planning.
Manage healthcare costs by influencing patient care decisions for value‑based care delivery, visit type, frequency and calendar plotting cadence based on medical necessity review and utilization management guidelines.
Assess real‑time patient clinical, functional, and behavioral health status to ensure rapid follow up and allocation of services.
Work alongside branch operations to ensure a holistic approach to patient care.
Contribute to the development of new or revised work processes, policies and procedures relating to the ASHN Care Management Program.
Plan of Care (POC) review and revision to reflect accuracy and regulatory standards.
Recertification/Discharge review and recommendation.
Utilization/Calendar Management.
Adhere to Utilization Management Guidelines.
Participate in Interdisciplinary Team Meetings and Agency Townhall Meetings.
Seek opportunities to contain cost.
Review charts to monitor compliance with regulatory and governmental regulations.
Meet productivity standards and workflow expectations.
Act as a resource for clinicians, agency staff, and internal staff.
Collaborate with clinicians as necessary for documentation clarification or educational opportunities.
Attend in‑service trainings and mandatory agency meetings.
Stay current with CMS guidelines and Oasis Guidelines.
Read and adhere to all Agency Policies and Procedures and follow Employee Handbook Guidelines.
Complete and submit all required documentation within specified company requirements.
Other duties as assigned.
Qualifications
Registered Nurse licensure required.
Two years home care field experience preferred.
One‑year clinical review preferred.
Two years case management and/or utilization management experience preferred.
Exceptional collaboration skills.
Self‑starter and innovative problem solver.
Proficiency in HCHB preferred.
Knowledge of Medicare, Medicaid and all State/Federal guidelines for compliance of patient clinical care.
Strong clinical acumen to thoroughly understand the patient’s health and functional status and foster effective communication.
Ability to create positive impressions and communicate effectively with a variety of people and personalities.
Active listener and ability to engage care team in the patient plan of care.
Projects a professional image during virtual communication.
Ability to set up work systems and engage in flexible problem‑solving behavior.
Observant and detail oriented.
Proficient in Microsoft Office including Excel, Outlook, PowerPoint and Word.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without reasonable accommodations.