Provides skilled nursing care in the home setting to patients ranging in age from adolescent through geriatric. Responsible for the overall management and of an assigned case load of patients, coordinating care with other nurses, multiple disciplines, physicians and community resources to achieve improved health and quality outcomes for patients.H/she practices in compliance with professional knowledge and standards of clinical practice and in accordance with policies and procedures of the agency, laws and regulations of Medicare, Medicaid and other third party payers. Demonstrates professional growth and accountability. Reports to and is supported by the Piedmont Home Health Clinical Manager.
Applies rules and regulations of Medicare, Medicaid, private insurers or other federally funded payers to determine initial and ongoing qualification for home care services to prevent fraud, waste or abuse.
Develops and implements a patient-centered plan of care with measurable outcomes, taking into consideration the goals and preferences of the patient and including the patient’s legal or patient-selected representative, if any, when appropriate.
Coordinates and facilitates a holistic approach in the provision of patient care through ongoing assessments, direct patient care, problem identification and resolution, specific therapeutic interventions and communication, coordination and follow up with other care team members.
Provides patient/family education and training activities to achieve improved health outcomes and self-actualization by the patient with regard to disease management.
Responsible for providing ongoing oversight of assigned case load of patients within a geographic territory.
Supervises the Home Health Aide in the provision of individual care to patients and assures that the Conditions of Participation are met for the supervision of home health aides.
Accurately documents care provided in accordance with law, regulation and agency policy to protect the financial resources of the agency.
Communicates routinely with the Home Health Clinical Manager.
KNOWLEDGE, SKILLS, ABILITIES
Knowledge of OASIS or ability to learn interpretive guidance quickly in order to assess patients accurately.
Knowledge of Medicare certified home health rules and regulations is desired; otherwise must posses the ability to learn quickly.
Must be creative and possess initiative and ability to work independently, as well as have the personal maturity and capacity for objective decision-making and problem resolution.
Must be flexible yet have a high level of integrity and accountability.
Able to work in isolation in varied environments with limited resources.
Strong communication skills necessary to effectively communicate with various individual, different levels of education, home environments or health literacy levels of patients and their caregivers.,
Able to apply the concepts of critical thinking and decision making in a variety of settings and issues.
Able to learn computer applications quickly.
MINIMUM EDUCATION REQUIRED:
Graduate of a professional nursing program.
MINIMUM EXPERIENCE REQUIRED:
Minimum of one year of nursing experience in acute care medical/surgical nursing.
Home Health experience preferred.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Current License in the State of Georgia as a Registered Nurse. BLS certification required. Valid Georgia driver’s license required.
Bachelor’s degree preferred. Nursing Experience in home health setting preferred. Prior case management experience a plus.
Diversity & Inclusion
At Piedmont Healthcare we embrace diverse ideas, perspectives, and skills to create a collaborative workplace where the best talent wants to succeed. We celebrate differences and recognize that they allow us to care for our community.
Excellence at Work
Piedmont is a certified Great Place to Work™-- a national designation based on employee feedback about trust, workplace culture and experience. In 2019, Forbes named Piedmont one of Georgia’s 10 best employers and the highest-ranked healthcare provider.