RN HomeCare Dimensions - 2204205

Location

Brownsville, TX | United States

Job description

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together. 

The Registered Nurse 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. 

Primary Responsibilities: 

• Completes an initial assessment of patient and family to determine home care needs. Provides a complete physical assessment and history of current and previous illnesses 
• Regularly re-evaluate patient nursing needs
• Uses health assessment data to determine nursing diagnosis
• Initiates and develops a Plan of Care, which establishes goals based on nursing diagnosis and incorporates therapeutic, preventative, and rehabilitative nursing care actions. Includes the patient and the family in the planning process. Makes necessary revisions as patient status and needs change
• Plans and implements patient health teaching and health counseling regarding the disease process(es), self-care techniques and prevention. Counsels and involves the patient and patients’ family in accomplishing healthcare goals, meeting nursing and related needs while promoting patient/family independence
• Re-evaluates patient nursing care needs to include continuous assessment using the OASIS Data Set at appropriate time intervals during the episode
• Assesses the patient’s condition during every home health care visit; ensures assessments are communicated to the Clinical Team Manager (CTM) on a daily basis; nursing interventions are implemented to meet patient needs and changing conditions
• Initiates appropriate preventive and rehabilitative nursing procedures. Administers medications and treatments as prescribed by the physician
• Identifies patient discharge planning needs as part of the Plan of Care development and implements prior to discharge of the patient
• Assumes responsibility to coordinate all patient care
• Recognizes and reports life threatening situations and responds appropriately
• Provides information regarding Home Medical Equipment (HME) and supply needs to the CTM, in a timely manner. Utilizes equipment and supplies effectively and efficiently 
• Performs care management duties for patients as assigned including: notifying the physician of changes in the patient’s condition or progress toward goals, obtaining physicians orders as needed, reassessing the patient for recertification, attending and documenting case conferences, initiating coordination of care by reporting significant findings to others on the healthcare team, and planning for notification and documenting the discharge of the patient
• Adheres to the Agency’s Standard Operating Procedures as it relates to the submission of documentation
• Documents all communications with the patient, family, physician, CTM, pharmacy, and other disciplines, as indicated on communication notes 
• Prepares a written plan for the certified Home Health Aide to follow, if applicable
• Established a trusting relationship with patients, caregivers, co-workers, clinic staff members, and physicians
• Demonstrates knowledge and observance of Patient Rights and Notice of Privacy Practices
• Follows all infection control standard precautions and safety guidelines/standards as per agency policy
• Participates in educational programs and all required in-service training programs to maintain comprehensive healthcare knowledge base, as assigned by supervisor 
• Complies with all Homecare Dimensions, Inc. agency’s policies and procedures. Promotes and maintains an agency environment that is in compliance with federal, state, and local regulatory agencies. Participates in the agency’s endeavors for accreditation, licensing, and professional recognition according to state, federal, and/or CHAP requirements. Participates in the Performance Improvement Program activities of the agency and periodic review of clinical records, as assigned

Communication: 

• Prepares clinical notes and updates the primary physician when necessary and at least every sixty (60) days
• Communicates with the physician regarding patient needs and reports any changes in patient condition; obtains/receives physician orders as required
• Communicates with community health related personnel to coordinate the Plan of Care
• Coordinates services and schedules with the Clinical Team Manager (CTM) and Clinical Team Coordinator (CTC/Scheduler) to include recommendations for additional home health care services for patients within twenty-four (24) hours of the Start of Care (SOC)

Additional Duties: 

• Participates in on-call duties within the on-call rotation schedule, to include weekends as assigned
• Ensures arrangements for equipment and other necessary items and services are available
• Instructs, supervises, and evaluates Home Health Aide care provided every two (2) weeks
• Instructs, supervises, and evaluates Licensed Vocational Nurses every thirty (30) days
• Maintains a daily patient case load and point of care documentation levels as per agency standards
• Requires the availability of accepting patients during business hours (8 a.m. – 6 p.m.)
• Requires updating the electronic timecard daily, as per UHG Policy
• Requires contacting patients the night before the scheduled visit to provide an arrival time within a two (2) hour window 
• Requires obtaining pre-approval from direct supervisor for overtime 
• Requires the ability to work flexible schedule to meet patient needs
• Demonstrates personal responsibility with regard to attendance and punctuality
• Maintains privacy and confidentiality with regard to all patient, staff, and agency information
• Demonstrates flexibility, enthusiasm, and willingness to cooperate while working with others or in place of others, as necessary
• Expresses verbal and written communication in a clear, positive, and collaborative manner
• Promotes the agency’s image by adhering to the agency’s dress code
• Performs all other related nursing duties as assigned

This job description is not intended, and should not be construed to be, an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended, however, to be an accurate reflection of those principal job elements essential for making decisions related to job performance, employee development and compensation. As such, the incumbent may perform other duties and responsibilities as required.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. 

Required Qualifications: 

• High school diploma or equivalent 
• Graduate of an accredited school of nursing
• Registered Nurse with an active unrestricted license to practice professional nursing in the state of Texas
• Have and maintain current CPR certification
• Must be able to work a variety of shifts including weekends, overnight and on call 
• Possess a valid Texas Driver’s License and maintain auto insurance coverage in accordance with organization requirement

Preferred Qualifications: 

• Bachelor’s Degree in nursing
• 2+ years of clinical experience preferable in a community home health or medical/surgical setting
• Experience working with electronic medical record application 
• Basic computer skills to include: Microsoft Word, Outlook, and other e-mail systems
• Bilingual (English/Spanish) language proficiency 
• Demonstrated knowledge of current nursing practice, professional standards of care, and state and federal regulations regarding home care

Skills and Abilities: 

• Demonstrates excellent observation, verbal and written communication skills, problem solving, basic math skills, and nursing skills per competency checklist
• Ability to define problem, collect data, establish facts, interpret an extensive variety of technical, medical, regulatory instruction and deal with numerous issues to draw a valid conclusion
• Evidence of independent nursing practice in delivering nursing care 
• Ability to endure prolonged or considerable walking or standing; lift position or transfer patients in a proximate location; lift supplies and equipment; perform reaching, stooping, bending, kneeling, or crouching
• Visual acuity and hearing, functional or corrected, to perform required nursing skills. Complies with accepted professional standards and practices
• Ability to prioritize and communicate objectives clearly
• Excellent verbal and written skills. Ability to interact productively with individuals and with multidisciplinary teams

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.    

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