Massachusetts:
Opportunity: Social Worker (MSW) Part-Time
We are a Home Health service provider seeking a MSW to join our growing team! Our patients are homebound and often in an assisted living setting.
Qualifications and Skills:
- Master of Social Work (MSW) License for Massachusetts (Required)
- Strong clinical skills (Prior Home Health Experience Preferred)
- Minimum requirement of two (2) year’s Home Care experience
- Knowledge of Federal and State laws and guidelines pertaining to Home Health
- Demonstrates good communications and public relations skills.
- Computer proficiency desired
- Knowledge of Home Care and Medicare/CoP regulations
Summary:
Work with a multi-disciplinary team of clinicians providing evaluation, treatment planning and implementation for homebound patients. Social Workers will follow their client from evaluation to discharge.
Responsibilities:
- Evaluates patients by conducting a thorough psycho social assessment related to the patient’s illness and environment.
- Develops reasonable, specific and measurable goals that support with the plan of care, are agreed upon by the patient/care giver.
- Encourages and promotes patient/family independence.
- Develops, evaluates, and revises patient care goals in conjunction with the patient and family.
- Coordinates goal directed, cost effective care for primary patients and demonstrates appropriate use of community resources to deliver comprehensive individualized care.
- Communicates with MD, family and interdisciplinary care providers to clarify care and increase awareness of significant changes in condition in a timely manner.
- Maintains effective working relationships with patients/families, referral sources, physicians, community resources and insurance representatives.
- Maintains and develops contracts with public and private agencies as resources for patient and organization personnel.
- Provide patient and family with appropriate information and materials necessary to support the learning process, i.e., home exercise program sheets and instruction sheets.
You will have a flexible schedule and utilize an electronic EMR which will help limits travel time and visit to the office.
RN Case Manager – Part-time
Opportunity: Home Health Case Manager – RN Required
The RN Case Manager plans, organizes and directs home care services and is experienced in nursing, with emphasis on community health education/experience. The professional nurse builds from the resources of the community to plan and direct services to meet the needs of individuals and families within their homes and communities.
Responsibilities and Duties:
- 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).
- 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.
- Communication with leadership as appropriate with a focus on patient care, documentation trends, star ratings and potential revenue impact.
- Compliance with Federal/State guidelines, rules, regulations, statutes and law.
Qualifications and Skills:
- Bachelor’s Degree
- Minimum requirement of two (2) year’s Home Care experience
- Knowledge of Federal and State laws and guidelines pertaining to Home Health
- Demonstrates good communications and public relations skills.
- Computer proficiency desired
- Knowledge of OASIS C, Home Care and Medicare/CoP regulations
Required education:
- Active Massachusetts Nursing License
