Role: Home Health RN – Full Time Assignment: Humana Cares/SeniorBridge Location: San Antonio, TX
Are you a fit? Humana Cares/Senior Bridge Care Management is seeking passionate, home health/case management professionals and leaders dedicated to delivering the highest quality in-home care management programs to complex chronically ill members enrolled in large health plans and managed care programs.
Assignment Capsule As a Home Health RN Field Care Manager you will provide direct care to members and their families according to the established plan of care. As a Field Care Manager you will provide a multidisciplinary approach to care.
The Field Care Manager position includes the following: * Completes an initial assessment of patient and family to determine home care needs. Provides a complete physical assessment and history of current and previous illness(es);
Serves as case manager in all cases nursing and therapy for which he / she may be conducting assessments and visits;
Is responsible for the clinical record for each patient receiving nursing services;
Regularly re-evaluates patient nursing needs;
Initiates the plan of care and makes necessary revisions as patient status and needs change;
Uses health assessment data to determine nursing diagnosis;
Develops a care plan, which establishes goals based on nursing diagnosis and incorporates therapeutic, preventive, and rehabilitative nursing actions. Includes the patient and the family in the planning process;
Initiates appropriate preventive and rehabilitative nursing procedures. Administers medications and treatments as prescribed by the physician;
Counsels the patient and family in meeting nursing and related needs;
Provides health care instructions to the patient as appropriate per assessment and plan of care.
Identifies discharge planning needs as part of the care plan development and implements prior to discharge of the patient.
Acts as Case Manager when assigned by Clinical Supervisor and assumes responsibility to coordinate patient care for assigned caseload.
Prepares clinical notes and updates the primary physician when necessary and at least every sixty (60) days; assures that progress reports are made to the physician, physician assistant, or advanced nurse practitioner when the patient’s condition changes or there are deviations from the plan of care;
Communicates with the physician regarding the patient’s needs and reports any changes in the patient’s condition; obtains/receives physician’s orders as required.
Communicates with community health related persons to coordinate the care plan.
Participates in on-call duties as defined by the on-call policy.
Ensures that arrangements for equipment and other necessary items and services are available.
Instructs, supervises and evaluates home health aide care provided every two (2) weeks.
Builds Trust: Walks the talk; makes choices that are consistent with Humana’s ethical principles; is emotionally intelligent; manages self and relationships effectively, through self-awareness, self-management, awareness of others and skill in dealing with others.
Implementation / Execution: Effectively leverages available resources (financial, people, time) to accomplish objectives and maximize return on investment. Makes appropriate decisions in the face of ambiguity. Anticipates and resolves barriers and constraints. Organizes and manages multiple priorities and/or projects using appropriate methodologies and tools.
Innovates: Introduces or develops new ideas and processes which improve performance and productivity. Generates insights through thought leadership. Leverages business intelligence, data, insights, and other research to drive differential value and expand Humana’s capability to compete.
Problem Solving: Proactively identifies, evaluates, and solves problems with rigorous logic and a systematic approach; looks beyond the obvious to see root cause issues and creative solutions.
Graduate of an accredited school of nursing. One (1) to two (2) years of recent acute care, certified home health experience in an institutional setting.
Current licensure in state and CPR certification.
One (1) year of home health care experience preferred.
Management experience not required. Responsible for supervising home health aides.
Excellent observation, verbal and written communication skills, problem solving skills, basic math skills; nursing skills per competency checklist.
Must be a licensed driver with an automobile that is insured in accordance with state/or organization requirements and is in good working order;
This role is considered patient facing and is part of Humana’s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Working knowledge of OASIS preferred;
Working knowledge of computer systems;
Knowledge of regulations and understanding of meeting state and federal requirements for respective services a plus;
Excellent verbal and written communication skills;
Sensitivity to cultural diversity and to making accommodation available to provide services to a diverse population;
Ability to work well under pressure; critical thinker;
Bi-lingual a plus Role Desirables :
Additional Information Please be advised, the role opportunity displayed here is for SeniorBridge, Inc. SeniorBridge Family Companies, Inc. is a wholly owned subsidiary of Humana Inc. Humana acquired SeniorBridge on July 6, 2012
Title: Full Time Home Health RN - Medicare Home Health - San Antonio, TX
Location: Texas-San Antonio
Requisition ID: 178508