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About the Role

Girling Health Care of NY is seeking an experienced and reliable RN Case Manager for our Brooklyn Office to manage the case management of quality home care services for patients.

Responsibilities

Apply age-specific criteria as appropriate.
Assess and treat patients with adult and geriatric needs.
Plan, implement, manage, and evaluate professional and ancillary home health services to meet patient needs and ensure quality care.
Establish and update care plans with input from patients, caregivers, physicians, and multidisciplinary teams.
Complete all required documentation accurately and timely, including interdisciplinary referral forms, 485s, OASIS, interim physician orders, and coordination notes.
Manage the activities of the multidisciplinary team providing patient care.
Ensure scheduled and provided visits are authorized and physician-ordered.
Review reports, evaluate ongoing patient care needs, and communicate them to the physician.
Contact and follow up with physicians and other care providers for care coordination.
Participate in staff/team meetings.
Maintain ongoing responsibility for assigned caseload.
Maintain proficiency in clinical and administrative skills.
Demonstrate sound judgment and problem-solving skills for appropriate interventions regarding psychosocial and/or physical impairments.
Facilitate patient care in the home setting by utilizing community resources, counseling, teaching, and advocating.
Communicate caseload and patient care issues to the Clinical Manager Supervisor.
Update Home Health Aide plan of care and communicate with the Home Health Aide Coordinator.
Develop, implement, and carry out discharge plans in conjunction with the Primary field, patient/caregiver, and healthcare team.
Interpret agency policy for patients and families.
Ensure all visits have prior authorization if required by managed care insurance.
Collaborate with the Authorization team.
Monitor the quality of therapeutic services through written and verbal communication.
Participate in performance improvement activities, team meetings, and orientation.
Participate in case conferences and/or clinical rounds to provide guidance and reinforce best practices.
Participate in the agency’s Quality Assurance Performance Improvement Program/PIP.
Work with the Interdisciplinary Team to develop interventions for patient goals.
Document accurately, timely, and completely in patient records according to CMS/DOH regulations.
Write accurate and concise clinical/progress notes reflecting plan implementation and patient response.
Demonstrate sound judgment regarding suspected violations of corporate compliance regulations.
Report all suspected violations to Supervisor, Compliance Officer, or Compliance Hotline.
Perform other nursing activities as directed.
Be compliant with conditions of participation for Center for Medicare/Medicaid Services.

Requirements

Graduate from an accredited School of Nursing.
Current Registered Nurse license with NYS Department of Education.
CHHA experience required.
Minimum of 1 year recent medical/surgical nursing experience.
Familiarity with MLTCP and commercial payer requirements for care.
Familiarity with EMR and computer applications (Word, Excel).
Basic computer proficiency, including Word, Excel, email, HHAX, EVV, and electronic case-management systems.
Ability to maintain confidentiality and handle sensitive consumer information.
Dependable, professional, flexible, and able to work independently.
Strong team player mentality.

Skills

Age-specific criteria application
Patient assessment and treatment
Care plan management
Documentation (interdisciplinary referral form, 485, OASIS, interim physician orders, coordination notes)
MLTCP and commercial payer requirements
Multidisciplinary team management
Physician communication
Community resource utilization
Counseling and teaching
Patient advocacy
Discharge planning
Performance improvement activities
Case conferences
Clinical rounds
Quality Assurance Performance Improvement Program/PIP
Interdisciplinary team collaboration
Clinical record documentation
Clinical/progress note writing
Corporate compliance reporting
Attention to detail
Organization
Follow-through
Verbal communication
Written communication
Customer service
Problem-solving
Case management
Prioritization
Deadline management

Location

Brooklyn Office

Work Type

Full-time

Experience Level

1 year recent medical/surgical nursing experience

Education Level

BSN preferred

About the Company

Girling Health Care of NY

Equal Opportunity

We are an equal opportunity employer. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, genetic information, or any other protected characteristic under federal, state, or local law. Reasonable accommodation is available per ADA and applicable state laws.