RN Case Manager-Home Health

Overview

As a Home Health RN Case Manager, you deliver skilled nursing care directly in patients' homes, using clinical expertise, assessment, and teaching to promote safe, high-quality outcomes. You develop and manage individualized care plans in collaboration with physicians and the interdisciplinary team, ensuring coordinated, patient-centered support.

Responsibilities

• Conduct skilled home visits to assess patient condition, provide ongoing nursing evaluation, and deliver care aligned with individualized plans of care.
• Complete comprehensive initial and ongoing assessments, identifying changes in condition and coordinating timely updates with physicians and the care team.
• Provide hands-on skilled nursing care, patient education, and caregiver training on disease management, medications, safety, equipment use, and emergency preparedness.
• Develop, implement, and continuously revise individualized care and discharge plans with measurable goals, ensuring patient and family involvement in all decisions.
• Promote patient safety and independence while proactively identifying risks for hospitalization and intervening to prevent avoidable complications.
• Coordinate care across the interdisciplinary team, communicate updates, and ensure physician orders are obtained, followed, and documented appropriately.
• Maintain accurate, timely clinical documentation, including visit notes, time tracking, verbal orders, and OASIS assessments in compliance with regulatory standards.
• Participate in case conferences, quality improvement initiatives, peer review, and interdisciplinary care coordination to support high-quality outcomes.
• Supervise home health aides and LPN staff as appropriate, ensuring safe, effective care delivery and proper documentation.
• Maintain productivity standards, participate in rotating evening/weekend coverage, and support a 24/7 care model while upholding professional communication and teamwork.

Qualifications

Education: Graduate of State Board approved program for Registered Nurses and valid license as RN in state(s) where providing care required. BSN preferred. MSN preferred.

Experience: One (1) year nursing experience caring for similar patient population as to be assigned required. Two (2) years of home care experience preferred. Two (2) years of nursing experience preferred.

License(s)/Certification(s): Valid RN license in the state(s) of practice, including eligibility under a NLC multistate license required. Dual licensed positions must obtain and submit proof of dual licensure within 90 days of hire/transfer. Valid driver's license required. Valid Auto Insurance required. Basic Life Support (BLS) certification required within 30 days of hire through the American Heart Association. Certificate for OASIS Specialist-Clinical required. IA & IL Dependent Adult Abuse Mandatory Reporter Training required within 90 days of hire. IA & IL Child Abuse Mandatory Reporter Training required within 90 days of hire. ANCC certification in area applicable to home care patient population preferred.