RN Case Manager – Home Health & Care Transitions (Day Shift)

Avera; United States; Remote; USD 43,000 - 64,000; Full time

Benefits offered by this job

PTO available day 1 for eligible hires

Up to 5% employer matching retirement

Career development guided by hands-on

Job summary

Avera at Home Sioux Falls is seeking an experienced Registered Nurse (RN) to manage patient care within the Care Transitions program, including assessments, follow-up calls, and home visits. You will coordinate with referring facilities and community resources to ensure a smooth discharge plan and ongoing care.

Responsibilities include implementing nursing processes, individualizing care plans, coordinating with home care agencies, and providing patient and caregiver education as part of a

Qualifications

• Registered Nurse (RN) - Board of Nursing, An active license in state of practice Upon Hire
• Previous home health or hospice

Responsibilities

• Implements the nursing process utilizing proficient assessment skills in the performance of admission and follow-up phone calls including documentation within the electronic medical record.
• Analyzes the assessment data and implements a plan of care individualized to the patient including expected outcomes, including efficient and effective utilization of resources to achieve positive outcomes.
• Manages the plan of care according to the patient needs and disease protocols including coordination and referral to home care agencies for home visits.
• Provides follow-up outbound phone call assessment and ensures appropriate referrals between services upon discharge from the Care Transitions program.
• Provides clinical management of patients calling in with symptoms and medical concerns, including appropriate triage.

Education

Registered Nurse (RN) - Board of Nursing, An active license in state of practice Upon Hire

Job description

Avera at Home Sioux Falls is seeking an experienced Registered Nurse (RN) to manage patient care within the Care Transitions program, including assessments, follow-up calls, and home visits. You will coordinate with referring facilities and community resources to ensure a smooth discharge plan and ongoing care.

Responsibilities include implementing nursing processes, individualizing care plans, coordinating with home care agencies, and providing patient and caregiver education as part of a