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Massachusetts Association of Public Health Nurses



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Case Manager

  • 08 Jan 2019 10:26 AM
    Message # 6989086


    The Home Care with Grace, LLC Registered Nurse will assist in all aspects of member and caregiver Initial Assessments and monthly home visits.  The primary responsibility will be supporting the CEO and Caregivers.   Additional responsibilities will include collecting and entering data into the HCWG databases as required by Home Care with Grace, LLC and by local, regional and national agencies.

    Support and Extension of Clinical Activities: 

    • Documentation of assessment, Nurse Care Plan and Bi-Annual Report in the medical record, organizational efficiency and follow-up with Primary Care Physicians.  

     Facilitates interactions of the multidisciplinary team members, including physicians, social work, and outside consultants. 
    • Acts as a liaison between Caregiver/Members and HCWG care team. 
    • Telephone contact with Member/Caregivers to assess clinical status, consultation with clinical providers, and organize follow-up as needed. 
    • Provides education to Caregiver/family members regarding important aspects of care, including but not limited to activity, diet, medication adherence and healthcare follow-up.  Helps to maintain current supply of patient/family education materials. 
    • Sets up monthly home visits.

    •Protects the client’s confidentially and rights and preserves dignity.

    •Seeks/maintains certification.

    •Seeks constructive feedback regarding his/her own practice.

    • Assists with communication and correspondence to/from caregivers, staff, Primary Care Physicians and insurance providers with regards to medication prescriptions, disability, family medical leave.  May also communicate and correspond with other providers (e.g., utility company, telephone company) as dictated by patient needs.  These duties may require telephone calls, faxes, mail and/or e-mail. 

    • Meets regularly with staff to facilitate quality and process improvement initiatives.  As requested, implements and assesses initiatives and summarizes results for team. 
    • Attends monthly clinical meeting as needed. 
    • Works with financial counselor and social work to assist patients/families in need of financial support, insurance coverage, medications, housing and/or utilities. 
    • Other duties as assigned.
    • Prior experience (3-5 years) in the care of Seniors and people with disabilities strongly preferred


    • Graduate of an approved school of nursing with current registration in Massachusetts.  BSN required.

    • Knowledge of community resources and post/non-acute care providers preferred

    • Familiarity with discharge and resource planning preferred

    • Active membership in a related professional organization is recommended

    We are dedicated in assisting seniors and adults with disabilities. There are many benefits to receiving care in your home, such as comfort, convenience and a possibly better quality of life. 

    Contact Ms. Grace DeSouza Home Care with Grace, LLC. 220 Winthrop Street Suite #203 Winthrop, MA 02152 Phone: 617-821-7218 Fax: 617-207-1586 homecarewgrace@yahoo.com www.homecarewithgrace.com

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