Home Health RN Case Manager

About Abby Care

Our mission is to redefine care for the most vulnerable families. We are transforming home health through purpose-built, thoughtful technology and a unique care model with families at the core.

What makes us the home health provider of the 21st century:

• Digital health integrations - We innovate to give our clinical teams superpowers. We build technology to decrease clinical administrative work and to improve the measurement of health outcomes.
  
• Clinical excellence - We strive to deliver the best-in class care to our families. Our culture encourages clinical growth and emphasizes quality in all our clinical processes.
  
• Family training and support - We believe that family care is key to a patient's wellbeing and health. Our care model incorporates family support into care plans.

The Role

We're looking for a passionate Registered Nurse to join our team as a RN Case Manager. This role will report into the Director of Nursing in Colorado. This is a Full-Time Hybrid opportunity based in Colorado Springs, CO. 

The RN Case Manager at Abby Care is responsible for overseeing the comprehensive care and coordination of services for patients within their caseload. This role requires a nurse with excellent organizational skills, strong communication abilities, and a dedication to providing high-quality patient care. The RN Case Manager will work closely with patients, families, Primary Care Physicians (PCPs), therapy providers, and internal support teams to ensure optimal patient outcomes.

Key Responsibilities:

• Patient Care and Coordination:
  • Manage a diverse caseload, ensuring quality patient care and efficient care coordination.
  • Provide coaching, oversight, and support to Certified Nursing Assistants (CNAs) to ensure high-quality patient care and adherence to clinical standards.
  • Develop and implement individualized care plans based on patient assessments and goals.
  • Coordinate with PCPs, therapy providers, and internal support teams to ensure comprehensive care.
  • Provide education and support to patients and families regarding their health care needs and treatment plans.
• Clinical Documentation:
  • Maintain accurate and timely electronic charting, with a preference for real-time documentation.
  • Ensure all documentation meets regulatory and Abby Care standards, with a minimum of 24-hour turnaround time.
• Communication and Collaboration:
  • Establish and maintain effective communication with PCPs, therapy providers, and internal support teams.
  • Escalate appropriate issues to Clinical Leads in a timely manner, such as order management and patient concerns.
  • Participate in on-call rotation (approximately one weekend per month), holiday rotation, and possible phone triage night coverage during weekdays.
• Quality Assurance:
  • Achieve caregiver satisfaction by providing high-quality, compassionate care and support.
  • Monitor and work to improve patient readmission rates.
  • Ensure extended visits remain within acceptable ranges and administrative tasks (e.g., mileage reimbursements) are completed thoroughly.

The Requirements

• An Associate's Degree or A Baccalaureate School of Nursing Degree.
• Current and valid license as a Registered Nurse in the state of Colorado or a Compact/Multi-state Unencumbered License required.
• 2 years of experience as a Registered Nurse in a clinical setting; 1 year of home health experience preferred.
• Case management/supervisor experience and pediatric/adult care experience preferred.
• Knowledge of Medicaid paid family caregiving program and CNA scope of practice preferred (training provided if needed).
• Reliable transportation, valid driver's license, and current auto insurance required.
• Ability to work flexible hours, travel locally, and provide on-call service to patients/families.
• Knowledge of OASIS preferred (training provided if needed).

Who We're Looking For

This role would be a fit for you if you have the following:

• Compassion: A deep commitment to providing empathetic and patient-centered care.
• Integrity: Upholds the highest standards of ethical and professional behavior.
• Resilience: Ab