Coordinate and participate in home visits and care conferences involving the member, their supports, and providers
Coordinate acute and primary care services, care transitions, and related follow-up care
Conduct in-person comprehensive, strengths-based assessment of the member's outcomes, needs and risks; perform reassessment as condition changes
Develop, coordinate, monitor and evaluate the members’ outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers
Implement risk mitigation strategies to promote the member’s health, safety and independence while respecting the member’s rights to appeal and grieve
Maintain member records as required by DHS contract and LCI policy
Build and maintain an effective and collaborative working relationship with Care Manager partner and various departments/stakeholders
Participate in team meetings and on-going trainings to stay abreast of policies, procedures, and state/federal regulations
Maintain the confidentiality of member information and protected health information (PHI) in accordance with HIPAA and state/federal regulations
Provide nursing care in accordance with the Nurse Practice Act
Requirements
Current License to practice as a Registered Nurse in the State of Wisconsin
Bachelor’s degree in nursing strongly preferred
Two (2) or more years of skilled nursing experience preferred, ideally in gerontology/disabilities and/or home care
Ability to access members’ homes which are not required to comply with the ADA regulations
Ability to lift up to 25lbs
Current driver’s license, acceptable driving record and proof of adequate insurance