Case Manager (RN)

BOONE MEMORIAL HOSPITAL INC•Madison, WV

8h•Onsite

About The Position

The Case Manager (RN) serves as a care coordinator for patients and families throughout the hospitalization and transition of care process. This role focuses on discharge planning, psychosocial assessment, coordination of post-acute services, and patient advocacy to ensure safe, timely, and effective transitions across the continuum of care. The Case Manager collaborates with physicians, nursing staff, patients, families, and community resources to support patient-centered care and continuity of services. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

Requirements

Current, unrestricted Registered Nurse (RN) license required.
Clinical nursing experience required; experience in case management, discharge planning, or care coordination preferred.
Strong communication, collaboration, and organizational skills.
Ability to assess and address psychosocial, cultural, and spiritual needs of patients and families.
Working knowledge of community resources, post-acute care services, and discharge planning processes.
Proficient in electronic health records and clinical documentation systems.
Demonstrates professionalism, sound judgment, and a commitment to patient advocacy.
Graduate of an accredited school of nursing required.
Current, unrestricted Registered Nurse (RN) license in the state of employment required.
Minimum of two years of clinical nursing experience required.

Nice To Haves

Experience in case management, discharge planning, or care coordination preferred.
Experience in discharge planning, case management, care coordination, or swing bed services preferred.
Experience in an acute care or hospital setting preferred.
CCM Certification preferred.

Responsibilities

Coordinates patient care and discharge planning from admission through discharge to ensure continuity of care.
Collaborates with physicians, nursing staff, and interdisciplinary team members to develop and implement individualized care and discharge plans.
Meets directly with patients and families to assess medical, psychosocial, cultural, spiritual, and support needs.
Coordinates referrals to appropriate community resources, social services, home health agencies, extended care facilities, rehabilitation services, and other support organizations.
Facilitates discharge planning arrangements including long-term care placement, home health services, medical equipment, meal delivery, and in-home assistance programs.
Participates in patient care conferences and interdisciplinary meetings as required.
Encourages patient and family involvement in care planning and decision-making.
Provides crisis intervention and support services as needed, including involvement in Emergency Department situations when appropriate.
Maintains timely, accurate, and complete documentation of discharge planning and care coordination activities in the medical record.
Communicates effectively with all departments to ensure patient needs are met and discharge barriers are addressed.
Supports patient rights, dignity, and respectful care at all times.
Maintains ongoing communication with referral sources and community partners.
Participates in performance improvement and quality initiatives related to case management and patient outcomes.
Assists with swing bed services and utilization review activities as assigned.
Performs other duties as assigned.