Hartford HealthCare at Home
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DescriptionJob Schedule: Full Time
Work where every moment matters.
Every day, over 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network as a Visiting Registered Nurse.
Hartford HealthCare at Home, the largest provider of homecare services in Connecticut, has been fulfilling our mission for more than 115 years. Our Person-Centered Care Model allows our employees to learn and grow within our organization, all while providing integrated support to the patient. As part of Hartford HealthCare, we leverage cutting edge technology to provide quality care in our client’s home. Most importantly, our employees are appreciated for the real differences they make in both the lives of their clients and their clients’ families.
The RN Case Manager provides the necessary and appropriate direct service; consultation and coordination to facilitate expected clinical outcomes for home care patients and their families. The RN coordinates the plan of care in accordance with the attending physician’s orders and Agency policies, procedures and practices. Delegates appropriate patient care responsibilities to LPN and Home Health Aides and supervises their performance. Teaches and orients LPN, Home Health Aide, patient and family members in the care of the patient. Responsible for accurate, timely, and proficient clinical and reimbursement documentation. Performs related duties in support of the Nursing Department and the Agency.
• Exhibits critical care case management skills.
• Recognizes and interprets significant physiological and environmental
alternations in patients condition and conferences/reports appropriately.
• Develops an appropriate care plan to meet individual patient needs an appropriate utilization under the direction of the M.D., and in collaboration with the patient/caregiver.
• Visits are consistent with plan of care in frequency and duration to obtain appropriate patient care outcomes.
• Meets Agency productivity standards.
• Implements the nursing care plan to provide safe, efficient quality care to patients.
• Communicates finding/updates and provides appropriate follow up to other Agency personnel.
• Evaluates the plan of care on an on-going basis, revising as necessary in accordance with patients' needs including appropriate referrals to other disciplines and/or specialty programs.
• Develops and maintains a respectful relationship with patients, caregivers, and physicians to ensure optimum patient outcomes.
• Develops a working knowledge of community resources and an ability to coordinate services with other agencies.
• Works in conjunction with LPN daily and delegates patient care responsibility as appropriate. Communicates with LPN daily and monitors patient care provided by LPN at least monthly.
• Responsible for clinical and reimbursement documentation to reflect Agency policy and procedure and the delivery of quality and safe Home Health Care.
• Monitors and assures that all paper work, and all necessary communications and other documentation is completed accurately and timely. Examples include, but not limited to: OASIS, MD Orders, patient discharge, patient authorizations, clinical notes, notification to other departments when primary service is being discharged, communications to MD, mailings, filing, data entry, billing etc.
• Prepares and keeps legible records current, on a daily basis, providing all written information regarding service record, visit and non-visit time, statistical sheets and reports to physicians and other personnel, according to expected time frames.
• Develops written patient care goals and expected outcomes according to individualized patient care plans, accurately reflecting interventions.
• Updates and submits written physician orders accurately, in a timely manner according to established timeframes.
• Collects and documents necessary financial and reimbursement information for each patient and provides verbal and written communication as required, to Agency personnel and other reimbursement sources.
• Obtains prior authorization for services when indicated by calling payers and requesting and/or providing verbal or written confirmation, in a timely manner within respective established time frames.
• Completes and processes discharge record within 24 hours after last patient visit, and communicates promptly with other Agency personnel, in an appropriate fashion.
• Delegates Home Health Aide patient care responsibilities and teaches, demonstrates, orients, and supervises performance of Home Health Aide.
• Assesses and develops Home Health Aide Plan of Care for each patient according to patient needs, updating as needed. Provides written Plan of Care individualized for each patient and orients each Home Health Aide to that plan.
• Responsible for orientation, supervision and evaluation of Home Health Aide performance per Agency policy and procedure.
• Completes a written performance evaluation for Home Health Aides, when requested, in a timely fashion.
• Teaches and demonstrates for the Home Health Aide with regard to specific patient care responsibilities i.e. diet, transfers, ambulating, personal care, etc.
• Teaches, demonstrates, orients, supervises and evaluates LPN, patient/family members and other appropriate caregivers, in the care of the patient.
• Explains the role and function of each Agency discipline to patients and families and the services which will be provided, in a clear and concise fashion to ensure proper understanding.
• Recognizes and respects cultural differences in regards to health care choices and end-of-life care, allowing the patient and family to practice within their cultural norms to ensure optimal outcomes.
• Willing to accept additional patient care visits i.e. after hours, on-call, or on the weekends with a professional attitude, to meet patient care needs.
Education & Training: Graduate of a National League of Nursing accredited program with a diploma or Associate Degree in Nursing. Bachelor of Science Degree in Nursing preferred.
License/Certification: Current Connecticut RN license, or eligible for RN license in the State of Connecticut, or current temporary RN permit.
Experience: Medical/Surgical experience or specialty area, if applicable, preferred. Experience in Home Health Care or Public Health Nursing preferred.
• Basic clinical nursing skills.
• Experience in physical and psychosocial assessment.
• Excellent verbal and written communication skills.
• Strong organizational skills.
• Excellent interpersonal skills; ability to effectively interact with patients, families, physicians and co-workers.
• Ability to deal effectively with stress and ability to exercise independent judgment.
Other: Valid motor vehicle operators license, reliable personal automobile during business hours, and active automobile insurance coverage in accordance with Agency policy.
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.