Job Description
**Job Title:** Registered Nurse (RN)
**Job Specialty:** Home Health
**Job Duration:** 260 Days
**Shift:** Day – 8×5 – 9:00 AM
**Guaranteed Hours:** Not specified
**Experience:** Minimum of two (2) years in a home setting within the last ten (10) years
**License:** Current RN License in New York State
**Certifications:** Basic Life Support (BLS) required before the start date
**Must-Have:**
– Two (2) years of experience in a home setting within the last ten (10) years
– Recent experience conducting comprehensive assessments of patients
– Experience with Certified Home Health Agency, Licensed Home Care Service Agency, or Managed Long-Term Care
– Ability to communicate and work effectively with multi-generational consumers
**Job Description:**
– Perform initial in-home pre-evaluation of patients, including evaluation of health status, strengths, care needs, and preferences.
– Guide the development of individualized long-term care service plans.
– Review consumer medical documentation and health referral forms, as relevant.
– Enter evaluation data into electronic forms and transmit as required.
– Document any concerns, conflicting information, or issues during the evaluation process.
– Emphasize continuity of care, reducing or eliminating fragmentation, duplication, and gaps in the treatment plan.
– Discuss healthcare options, supports needed, service vendor options, and waiver options with consumers.
– Initiate communication with eligible consumers for enrollment into a managed care health plan.
– Enhance communication and collaborative relationships with interdisciplinary care team members to improve care coordination and facilitate service delivery.
– Collect quality review data and required documentation to support outcome measurements and record case notes.
– Identify opportunities for health promotion and illness prevention.
– Maintain a comprehensive working knowledge of community resources, payer requirements, and network services for the target population.
– Meet all established standards as outlined in annual performance criteria.
– Perform other duties as assigned by the Regional Nurse Manager or project management.