Case Manager

Essential Duties and Responsibilities

Complete comprehensive patient assessments, including OASIS documentation, within required timeframes. Develop, implement, and update individualized plans of care based on patient needs. Coordinate all clinical services provided by the interdisciplinary care team. Serve as the primary clinical contact for assigned patients and their families.

Provide skilled nursing care in accordance with physician orders and accepted nursing standards. Monitor patient progress and revise care plans as appropriate. Communicate changes in patient condition promptly to physicians and appropriate team members. Ensure timely completion of documentation, including visit notes, care plans, physician orders, and OASIS assessments.

Educate patients and caregivers regarding disease management, medications, treatments, and available community resources. Participate in case conferences and interdisciplinary team meetings. Coordinate discharge planning and transition of care. Ensure compliance with Medicare, Medicaid, state licensing requirements, accreditation standards, and agency policies.

Supervise and provide clinical oversight to Licensed Practical Nurses (LPNs), Home Health Aides (HHAs), and other assigned staff as applicable. Participate in quality improvement initiatives and infection prevention activities. Maintain patient confidentiality in accordance with HIPAA regulations. Perform other duties as assigned.

Qualifications

Current Registered Nurse (RN) license in the State of Washington (or applicable state). Minimum one (1) year of clinical nursing experience required. Home health, hospice, or case management experience preferred. OASIS documentation experience preferred. Current CPR/BLS certification. Valid driver's license, reliable transportation, and current automobile insurance.

Ability to travel throughout the agency service area. Knowledge, Skills, and Abilities Knowledge of Medicare Conditions of Participation and home health regulations. Strong clinical assessment and critical thinking skills. Excellent organizational and time management abilities. Effective verbal and written communication skills.

Ability to work independently while managing multiple patient cases. Proficiency with Electronic Medical Record (EMR) systems. Strong patient education and care coordination skills. Ability to establish positive relationships with patients, families, physicians, and interdisciplinary team members. This job description is intended to describe the general nature and level of work performed and is not intended to be an exhaustive list of all responsibilities, duties, and qualifications required.

Duties may be modified at the discretion of the agency to meet operational needs. Salary $55 - $65 per hour