Registered Nurse (RN) Case Manager - Emergency Department - Lorain Hospital

Mercy Health BSMH • Lorain, OH

6d

About The Position

The Registered Nurse Case Manager serves as the principal liaison between the Emergency Department, nursing, finance, and physicians to support appropriate bed placement, meet patient care needs, and ensure treatment plans are carried out at the appropriate level of care. The role provides care appropriate to the ages of patients served and begins discharge planning in the emergency room. The nurse identifies multidisciplinary referrals and ensures patients leaving the Emergency Room have the resources needed for a safe discharge.

Working with licensed social workers, patients, families, and the health care team, the Case Manager develops and coordinates discharge plans. The role arranges post-acute services and resources, addresses barriers to discharge, obtains insurance authorizations, and supports timely patient placement and Emergency Department throughput. The position is a collective bargaining unit role.

Requirements

• Bachelor’s degree in Nursing.
• Nursing licensure from the Ohio Board of Nursing.
• CPR certification.
• At least 3 years of nursing clinical experience.
• Ability to foster change within a workgroup or unit and operate in a highly dynamic work environment.
• Exceptional customer service skills.
• Strong critical-thinking skills, including the ability to analyze clinical, financial, and social situations and identify problems and alternative courses of action.
• Flexibility, resourcefulness, creative problem-solving, and prioritization skills.
• Ability to guide and direct the health care team to support patient flow and Transformation outcomes.
• Ability to organize and present information clearly and concisely.
• Strong interpersonal and communication skills for working with physicians, patients, families, and interdisciplinary team members.

Nice To Haves

• Bachelor of Science in Nursing (BSN).
• AACN-RN or CCM certification.
• Experience with Utilization Review and Case Management.

Responsibilities

• Collaborate with licensed social workers, patients, families, and the health care team to develop discharge plans that meet patient needs.
• Arrange durable medical equipment, transportation, community referrals, nursing home placement, rehabilitation, and other discharge needs.
• Work with community agencies to help patients obtain needed discharge services.
• Coordinate insurance authorizations and precertification for post-acute services.
• Assess patients’ ability to purchase medications, supplies, and durable medical equipment, and provide available resources.
• Meet with patients and families to discuss barriers to discharge.
• Initiate timely discharge planning and reassess or revise plans as needed.
• Arrange appropriate levels of care in compliance with third-party payer requirements and federal and state regulations.
• Promote patient and family choice among appropriate services, including intermediate care, skilled nursing, rehabilitation, home health, hospice, foster care, group homes, substance use treatment, and specialized programs.
• Work with the Emergency Room physician and multidisciplinary team to remove barriers to discharge.
• Promote financially sound decisions consistent with the organization's mission.
• Assist the Emergency Room, HUB, and Nursing Supervisor with timely patient placement and Emergency Department throughput.
• Maintain compliance with CMS requirements.

Benefits

• Competitive pay, incentives, referral bonuses, and a 403(b) with employer contributions when eligible.
• Medical, dental, vision, and prescription coverage; HSA/FSA options; life insurance; mental health resources; and discounts.
• Paid time off, parental and FMLA leave, short- and long-term disability, and backup care for children and elders.
• Tuition assistance, professional development, and continuing education support.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level