Patient Case Manager

Job Description

Job Description

Case Manager – Home Health Agency

Job Title: Case Manager
Department: Home Health
Reports To: Director of Nursing / Clinical Manager
Employment Type: Full-Time

Position Summary

The Home Health Case Manager is responsible for coordinating and managing patient care services to ensure the delivery of high-quality, cost-effective care in the patient's home. The Case Manager works collaboratively with physicians, nurses, therapists, patients, families, and community resources to develop, implement, and monitor individualized care plans that promote optimal patient outcomes.

Essential Duties and Responsibilities

• Conduct comprehensive patient assessments and develop individualized plans of care.
• Coordinate and oversee the delivery of home health services in accordance with physician orders and agency policies.
• Monitor patient progress and modify care plans as needed.
• Serve as the primary point of contact for patients, families, physicians, and interdisciplinary team members.
• Ensure timely completion and accuracy of all clinical documentation.
• Review and maintain compliance with Medicare, Medicaid, state, federal, and agency regulations.
• Facilitate communication among healthcare providers to ensure continuity of care.
• Educate patients and caregivers regarding diagnoses, treatment plans, medications, and available community resources.
• Participate in case conferences and interdisciplinary team meetings.
• Identify patient needs and coordinate referrals for additional services when appropriate.
• Monitor utilization of services and promote efficient resource management.
• Maintain patient confidentiality and adhere to HIPAA regulations.

Required:

• Current and unrestricted Registered Nurse (RN) license (preferred) or Licensed Vocational Nurse (LVN/LPN), depending on state regulations.
• Minimum of one (1) year of clinical experience in home health, hospice, case management, or a related healthcare setting.
• Knowledge of Medicare Conditions of Participation and home health regulations.
• Excellent communication, organizational, and problem-solving skills.
• Proficient in electronic medical records (EMR) systems.
• Valid driver's license, reliable transportation, and current auto insurance.

Preferred:

• Bachelor's degree in Nursing or related healthcare field.
• Prior case management experience in a home health setting.
• OASIS documentation experience.
• Case Management Certification (CCM) preferred.

Physical Requirements

• Ability to travel within the agency's service area.
• Ability to sit, stand, walk, bend, and lift up to 25 pounds.
• Ability to perform home visits in various environments.