Registered Nurse (RN) Case Manager - Prince George's County - Capital Caring Health

It’s inspiring to work with a company where people truly BELIEVE in what they’re
doing!

When you become part of the Chapters Health Team, you’ll realize it’s more than
a job. It’s a mission. We’re committed to providing outstanding patient care and
a high level of customer service in our communities every day. Our employees
make all the difference in our success!

Job Profile Summary

Role

The RN, Case Manager is responsible for assessing and identifying patient/family
needs, utilizing the nursing process, coordinating the Plan of Care with the
Interdisciplinary Team (IDT), and providing clinical, palliative and supportive
care to the patient/family unit in order to keep the participant in their home
environment as long as possible.

Job Description

Qualifications

• Current license as RN in the state where the employee will be working

• Minimum of one (1) year nursing experience; hospice or hospital experience

• Employees working at PACE, certification of completion of Alzheimer's Disease

• Previous experience working with an EMR/EHR (Electronic Medical/Health Record)

• Mobile Driver - Valid driver’s license and automobile insurance per Company

• Reliable transportation to meet visit schedule

• Ability to use equipment with visual and auditory mechanisms

• Ability to effectively communicate in English (verbal and written)

• Ability to visit Participant in their homes to assessments

• Ability to perform the essential functions and physical requirements

• Active BLS for healthcare professionals from the American Heart Association or

Some locations may require

* Provides reassurance on the phone to patients and families. Assists in
finding solutions to their questions and/or recognizes the need for an in
person visit. Coordinates in person visit when needed/or requested.
* Utilizes appropriate support/expert resources or personnel to resolve complex
or difficult situations.
* Documents patient/family contact information in the EMR and communicates with
the Interdisciplinary Team (IDT).
* Completes initial and semi-annual assessment for all Company services

including, but not limited to

* Explains services to patients/families and addresses questions regarding
patient needs, fears, physical limitations, while putting the
patient/family at ease; presents services in an empathetic and
compassionate manner 
* Provides information to Physicians and other IDT members and initiates Plan
of Care to address patient’s immediate needs
* Initiates skilled nursing interventions to enhance prevention, prevent
complications, alleviate symptoms and maximize physical and emotional
comfort
* Obtains Physician orders
* Completes documentation per Company policy

* Acts as the Company representative at assigned facilities while facilitating
referrals to all service lines; works closely with referring hospitals,
physicians, facilities, patients, families, and the general public.
* Communicates frequently with other members of the IDT.
* Provides all necessary clinical communication timely using SBAR.
* Discusses any potential needs with after-hours staff.
* Develops strong relationships with case managers, physicians, etc. at
facilities.

Competencies

• Satisfactorily complete competency requirements for this position.

Responsibilities of all employees

• Represent the Company professionally at all times through care delivered

• Comply with all State, federal and local government regulations, maintaining a

• Comply with Company policies, procedures and standard practices.

• Observe the Company's health, safety and security practices.

• Maintain the confidentiality of patients, families, colleagues and other

• Use resources in a fiscally responsible manner.

• Promote the Company through participation in community and professional

• Participate proactively in improving performance at the organizational,

• Improve own professional knowledge and skill level.

• Advance electronic media skills.

• Support Company research and educational activities.

• Share expertise with co-workers both formally and informally.

• Participate in Quality Assessment and Performance Improvement activities as

Job Responsibilities

• Provides and manages direct care to patients and families as part of

• Coordinates the Plan of Care, ensuring that an individualized Plan of Care is

• Educates patient, family, caregivers and other health professionals about

• Participant visit frequency dependent on risk score/needs to be determined

• Home visits to assess home safety, medication compliance, nutritional

• Reports changes in the patient’s condition to appropriate members of the IDT

• Participates with the IDT to evaluate hospice referrals/admissions for level

• Attends daily IDT collaboration meetings

• Presents concise and pertinent oral and written reports to IDT; respects and

• Communicates accurately and completely to physicians, staff members, patients,

• Supervises patient care provided by Community Health Workers and Home Health

• During times of emergencies (i. e. Hurricanes, etc.), the RN, Case Manager may

• Performs other duties as assigned.

Physical Demands for Post Offer/Pre-Placement (The demands described below are
representative of those that must be met by an individual to perform the
essential functions of the job, with or without reasonable accommodation.):

While performing the duties of this job, the following abilities are required:
see; hear; talk; walk; use hands to finger, handle or feel.

Frequently required to: stand; sit; reach with hands/arms; lift; bend; balance.

Occasionally required to: pull; push; stoop/crouch; kneel; climb stairs.

Compensation Pay Range

$69,720.00 - $103,771.25

This position requires consent to drug and/or alcohol testing after a
conditional offer of employment is made, as well as on-going compliance with the
Drug-Free Workplace Policy.

All Chapters Health System employees performing services for Florida affiliates
are submitted through the Florida Care Provider Background Screening
Clearinghouse to verify eligibility after a conditional offer of employment is
made as well as ongoing eligibility. For more information, please visit
https://info.flclearinghouse.com/ [https://info.flclearinghouse.com/].