HCBA OCM RN Case Manager Fresno

JOB DESCRIPTION

Position: OCM RN Case Manager

Pay Range:$95000 -$105000PER YR

Reporting To: Lead OCM RNCase Manager

Work Type: Remote

POSITION SUMMARY:

The OCM RN Case Manageris responsible forthe clinical care and coordination of services provided to patients in their home or place of residence. This includes providing clinical services such as comprehensive assessments administration and management of medications or performing treatments ordered by the physicianidentifying organizing coordinating andmonitoringservices needed by a recipient.

QUALIFICATIONS:

• Must have a current unsuspended un-revoked license to practice as a Registered Nurse in California.

• Knowledge of the current Nursing Practice Nursing Practice Act (NPA) is the body of California law that mandates the Board to set out the scope of practice and responsibilities for RNs. The NPA is in the California Business and Professions Code starting with Section 2700. Regulations which specify the implementation of the law appear in the California Code of Regulations.

• Possesses current CPR certification.

• Proficient in the use of computers.

• Minimum two (2) years experience in a home health organization primary care clinic or a health facility. One (1) year experience in healthcare quality management preferred.

• Current and satisfactory report on pre-employment physical examination including TB Screening Test or chest X-ray as required by Agency policies and procedures. Must be free from signs of infection and illness.

• Exercises excellent judgment andpossessesknowledge of current nursing practices withdemonstratedexemplary clinical analytical and documentation skills.

• Possesses good written and verbal communication skills. Fluent in English.

• Must be a licensed driver with an automobile that is insured and is in good working orderin accordance withstate and/or organizational requirements.

• Familiarity with Title 22

ESSENTIAL DUTIES AND RESPONSIBILITIES:

The following is a representation of the major duties and responsibilities of this position. The Registered Nurse will use the nursing process to assess and manage the patients medical needs. The Agency willmakereasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions. The RN will provide andmaintainproper licensure and provide such to the Agency.

• Provides nursing services as part of the Case Management Team for each assigned caseload and client.

• Ensures proper tracking charting progressnotesand case records for each enrolled clientwithin time guidelines and assures completion according to Agencys policies and patient intervention and response foraccurateintervention using established guidelines.

• Ensuresproper timekeeping and scheduling as discussed with supervisor.

• Works collaboratively with the Social Worker on their Case Management Team (CMT).

• Completes assessments and reassessments based on the timeline determined upon a participants enrollment in the program.

• Follow up with the participant after emergency and inpatient facility admission.

• Reports all incidents and issues that arise before after or during an assessment to the lead RN.

• Maintain all scheduled visits on the calendar.

• Review all documents associated with the applicant to be prepared before completing assessment.

• Completes all assessments within the outlinedtimeframewhich isstatedin the HCBA policy and procedure handbook.

• Manages complaints from clientsfamiliesor friends.

• Reports all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or neglect occurs in an RCFE) or DHCS and APS (if abuse or neglect occurs in PH).Reportsfraud.

• Reviews the Significant Incident Reports (SIRs) with client and staff as necessary.

• Participates in EducationTrainingand Quality Improvement Activities. Monitors compliance andassistsAgency inmaintainingcompliance with Federal State Local and HIPAA Regulations as well as Joint Commission Standards and Labor Laws.

• Screens applications/applicants for HCBA Waiver todetermineif the applicant meets the minimum HCBAWaiverLOC eligibility requirements.

• Schedules and conducts comprehensive health and psychosocial assessments of participants medical needs diagnosis functional and cognitive abilities and environmental and social needs todeterminewhich service(s) arerequiredto meet participants needs and preferences in the community. Works with MSW to perform initial evaluations and works with applicant his or her legal representative circle of supportphysicianand providers to develop a Plan of Treatment to:

  • i. Develop goals associated with the participants assessed needs individualcircumstances and preferences.

  • ii. Mitigate risk and minimize disruptions in services.

  • iii. Identify when services outlined in POT are available through friends family and/or publicly funded programs.

  • iv. Implementthe POT which includesidentifyingservice providers and community resources to help assure thetimely effective and efficient mobilization and allocation of services.

  • v. Identify (and train if necessary) backup caregivers who are willing and able to provide unpaid support if waiver service providers are not available.

  • vi. Provide information education counseling and advocacy to and on behalf of participants.

• Provides information education counseling and advocacy to and on behalf of participants.

• Monitors the delivery of HCBA Waiver Services to ensure participants are receiving services as authorized in their POTs.

• Respects the patients and familys rights and property as defined by the federal and state laws.

• Alwaysmaintainsand conserves confidentiality of patient and agency information conforming to HIPAA regulations.

• Regularly attend andparticipatein scheduled case conferences staffmeetingsand Agency in-services (in person by phone or by web).

• Participates inappropriate continuingeducation as may be requested and/or required by immediate supervisor.

• Regularly self-assess nursing skills and educational needs to meet the nursing care requirements of patients assigned for care. Upgrades professional skills and attends in-services and continuing education classes as needed.

• Attending all State mandated in-servicetrainings.

• Conforms to all agency policies and procedures.

• Provides Agency of current licensure for RN. Maintains licensure and provides Agency proof of such.

• Maintain all required credentials up to date.

• Familiarity with Title 22.

• Maintainscomfortablework environment for all employees.

• Maintains constant communication with departmentteam.

• Enhancesefficiency and productivity of procedures and employees.

• Maintains positive customer satisfaction/service.

• Significant amount of driving may berequiredthroughout LA Fresno SanBernardinoand Ventura County.

• Performs other duties as assigned.

PHYSICAL REQUIREMENTS:

• Stand sit talk hear reach stoop kneel and use of hands and fingers tooperatecomputer telephone and keyboard on a frequent basis (up to 75% of the time).

• Close vision requirements due to computer work.

• Light to moderate lifting may berequired(Up to 25lbs).

• Some driving/traveling may berequiredup to 25% of the time.