Judson at Home Resident Care Manager

General Purpose:

The RN Case Manager for Judson Link extends Judson Senior Living’s expertise, programs, and services into the community by providing nursing assessments, care coordination, education, and resource navigation to older adults and their family caregivers. Responsibilities include assessment and coordination of care; education and support; extension of Judson’s expertise through community relationships and outreach; supervision and guidance to associates providing direct care services to members. This role works collaboratively with an interdisciplinary team to provide coordinated care to maintain maximum wellness and independence of the clients served through Judson Link.

Essential Duties and Responsibilities:

· Makes home visits to prospective and current members – for assessment, intake, and alignment with appropriate level of care.

· Delivers and coordinates care management services, providers, and transition of care. Makes referrals for other services as appropriate.

· Provides care navigation support to help members and their families understand options and access resources.

· Maintains responsive, effective communication with members and families. Actively listens to member and family concerns and identifies solutions.

· Ensures that all information is updated and accessible within the client record system.

· Monitors care delivery, initiates and participates in care conferences, makes changes as needed to care plan for members receiving home care or smart living professional services, and maintains effective communication with interdisciplinary teams.

· Coaches and mentors home care aides to improve care delivery.

· Provides health, wellness, caregiving, and age-related education for members, their families, and the community. Facilitates conversations around planning for aging.

· Develops new assessment procedures for potential members.

· Completes annual member reassessments, or more frequently if necessary, and updates member face sheets to include diagnosis, medications and contact information for physicians, emergency contacts, and advanced directives.

· Collaborates with the customer service manager regarding concierge and other non-health related concerns and needs to ensure person-centered care.

· Collaborates with the administrative and marketing team regarding potential member needs and options for expansion of services.

· Supports program growth through community outreach and partnership development.

Other Duties:

· Conducts employee supervisory visits to monitor competency levels of care provided by HHAs to clients.

· Provides on-call coverage after hours

· Responds promptly to all pages regarding all clinical care situations for members.

· Participates in Quality Improvement initiatives.

· Prepares and submits monthly documentation for billing.

· Maintains a record of acceptable attendance and punctuality.

· Observes all company rules and safety procedures.

· Other duties as assigned.

Minimum Qualifications, Education and Certifications:

Required Qualifications:

· Current Registered Nurse (RN) license with three years nursing experience and one year supervisory.

· Community/home care experience is required with case management experience preferred or willingness to become certified.

· Must possess a valid Ohio driver’s license.

Other necessary skills include:

· Proven record of reliability, dependability, accuracy and attention to detail, excellent interpersonal and communication skills

· Good assessment, analytical and problem-solving skills

· Must have an understanding and acceptance of the philosophy of care of JHC

· Managerial experience regarding hiring, discipline, performance appraisals, etc.

· Proficiency on windows-based computer word processing and spreadsheet software is necessary

Physical Requirements:

The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job:

Requires good vision, hearing, speech and communication skills with the ability to ambulate, project voice, use the telephone, use the computer and read and write English. In addition, the employee must be able to stand on her/his feet for a period of up to eight (8) hours a day, move around the home without difficulty, transfer a 150-pound person and squat on the floor and rise to standing.

Working Conditions:

The work environment characteristics described here are representative of those an associate may encounter while performing the essential functions of this job:

The office-working environment is conducive to be able to computerize essential data, communicate effectively on the telephone and communicate effectively with referrers, caregivers, supervisors, R/Cs and responsible or interested parties. When away from the office, must be within paging and (cell) telephone range to effectively communicate scheduling changes. Also, must have access to updated information (i.e. employee. Supervisor and Resident data) at all times.

The individual home-work environment characteristics described here are representative of those an associate may encounter while performing the essential functions of this job and may vary from residence to residence. Some of the variations include:

· Pets

· Smoking

· Family members

· Traveling to various locations

· Other as dictated by the individual environment

Each home or residence (working environment) has a “Home Safety Evaluation” conducted at the admission of each case by the RN Community Care manager to confirm that the home environment is safe and to make recommendations as necessary. Flexibility in work hours may be necessary.

Acknowledgement: The above statements are intended to describe the general nature and level of work being performed by associates assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified, and such responsibilities, duties and skills may be changed by Judson Services, Inc. management at any time.