RN Case Manager

About Company:

The mission of Omni Healthcare Services is to use our highly qualified team of professional staff to assist out clients in maintaining and improving their quality of life in the comfort of their homes.

We provides services at the residents’ homes involving direct care to the client. Each client is staffed appropriately to suit their individual needs. Whether ambulatory or not, wheelchair-bound, bedridden, or convalescing.

Omni Healthcare Services will supply the client with Registered Nurses, Licensed Practical Nurses, Personal Care Attendants, or Sitters/Companion

About the Role:

The RN Case Manager plays a critical role in coordinating and managing patient care to ensure optimal health outcomes and efficient use of healthcare resources. This position involves assessing patient needs, developing individualized care plans, and collaborating with multidisciplinary teams to facilitate seamless care transitions. The RN Case Manager acts as a liaison between patients, families, healthcare providers, and insurance companies to advocate for appropriate services and support. By monitoring patient progress and adjusting care plans as necessary, the RN Case Manager helps reduce hospital readmissions and improve overall patient satisfaction. Ultimately, this role contributes to enhancing the quality of care while managing costs within the healthcare system.

Minimum Qualifications:

• Current and valid Registered Nurse (RN) license in the United States.
• Bachelor of Science in Nursing (BSN) or equivalent nursing degree.
• Minimum of two years clinical nursing experience, preferably in case management, acute care, or related healthcare settings.
• Strong knowledge of healthcare systems, insurance processes, and patient care coordination.
• Excellent communication, organizational, and critical thinking skills.

Preferred Qualifications:

• Certification in Case Management (CCM) or Accredited Case Manager (ACM) credential.
• Experience with electronic health records (EHR) and case management software.
• Familiarity with Medicare, Medicaid, and other insurance program guidelines.
• Background in chronic disease management or utilization review.
• Advanced degree in nursing, healthcare administration, or related field.

Responsibilities:

• Conduct comprehensive assessments of patients' medical, psychosocial, and environmental needs to develop personalized care plans.
• Coordinate with physicians, nurses, social workers, and other healthcare professionals to implement and monitor care plans effectively.
• Facilitate communication between patients, families, and healthcare providers to ensure understanding and adherence to treatment plans.
• Manage utilization of healthcare services by reviewing medical records, authorizing treatments, and ensuring compliance with insurance requirements.
• Provide education and support to patients and families regarding disease management, medication adherence, and available community resources.
• Monitor patient progress and outcomes, adjusting care plans as needed to address changing health conditions.
• Document all case management activities accurately and timely in compliance with regulatory and organizational standards.
• Participate in quality improvement initiatives and contribute to the development of best practices in case management.

Skills:

The RN Case Manager utilizes clinical expertise and critical thinking skills daily to assess patient conditions and develop effective care plans. Strong communication skills are essential for collaborating with multidisciplinary teams and educating patients and families about treatment options and health management. Organizational skills enable the RN Case Manager to manage multiple cases simultaneously while ensuring compliance with regulatory requirements and documentation standards. Proficiency with healthcare technology, including electronic health records and case management software, supports efficient tracking and reporting of patient progress. Additionally, knowledge of insurance processes and healthcare regulations helps the RN Case Manager navigate authorization and reimbursement challenges to optimize patient care delivery.