Home Health Care RN Case Manager

Job Description

Job Description

Registered Nurse Case Manager – Home Health

Schedule & Coverage

• Monday–Friday, 8:00 AM – 5:00 PM
• One week of on-call coverage required monthly (light/easy on-call rotation)
• Mileage reimbursement provided at $0.45 per mile
• Coverage territory includes Culpeper to Charlottesville

Position Overview

We are seeking an experienced and compassionate Registered Nurse Case Manager to provide high-quality home health care coordination and clinical oversight for patients in the community. This role focuses on comprehensive patient assessments, care planning, coordination of services, and improving patient outcomes through effective case management and interdisciplinary collaboration.

Key Responsibilities

• Perform comprehensive assessments for high-risk patients in the home health setting
• Collaborate with primary care providers and interdisciplinary teams to develop and implement individualized care plans
• Continuously evaluate and reassess appropriate levels of care to ensure cost-effective and quality patient outcomes
• Coordinate transitions of care and communicate with physicians, social workers, discharge planners, and other healthcare professionals
• Arrange supportive non-medical services, including transportation and housing resources, to promote treatment compliance
• Maintain detailed documentation of clinical, functional, and financial outcomes throughout the care management process
• Identify opportunities for health promotion, illness prevention, and improved patient engagement
• Proactively intervene to prevent adverse patient outcomes and address issues quickly when prevention is not possible
• Serve as a patient advocate while maintaining strict confidentiality and HIPAA compliance
• Ensure all documentation and patient care activities comply with company standards, professional practice guidelines, and federal/state regulations

Required Skills & Experience

• Active Multi-State Registered Nurse license required
• Home Health experience required
• OASIS and HCHB (Homecare Homebase) experience required
• Current CPR/BLS certification required
• Successful completion of wound/competency testing required
• Current TB test required
• Strong clinical assessment, critical thinking, and care coordination skills
• Ability to analyze complex medical information and make sound clinical decisions

Qualifications

• Associate’s Degree in Nursing or related field required
• Current, unrestricted Registered Nurse license
• Case Management certification preferred
• Experience with Homecare Homebase strongly preferred
• Excellent communication, documentation, and patient advocacy skills