Registered Nurse Case Manager

Inova Health System • Falls Church, VA

10d • $86,091 - $140,338 • Onsite

About The Position

Inova Fairfax Hospital is looking for a dedicated Experienced Registered Nurse Case Manager 1 to join the Case Management Team. This role will be Full-Time. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Requirements

• Basic Life Support (American Heart Association)
• Licensed or eligible for licensure in the Commonwealth of Virginia as a Registered Nurse or an active multi-state Registered Nurse license
• 1 year of case management and/or clinical care experience
• Bachelor's Degree Nursing or Associate's Degree. If RN has an Associate's Degree, within 2 years of date of hire, they must meet with their nurse leader and conduct the following: 1.) Identify which accredited school they plan to attend 2.) Provide a written plan with anticipated BSN completion date 3.) Submit a review of transcripts from the school indicating the required pre-requisites and timeline for taking the courses 4.) Complete BSN within 5 years of start date.

Responsibilities

• Collects delay and other data for specific performance and/or outcome indicators. Assists in the collection and reporting of resource and financial indicators including acute and post-acute case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals.
• Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently. Ensures safe care to patients by adhering to policies, procedures and standards within budgetary specifications including time management, supply management, productivity and accuracy of practice.
• Provides discharge planning and continuity of care for assigned patients in the acute and post-acute setting. Initiates and facilitates referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated.
• Collaborates/communicates with internal and external case managers. Understands pre-acute and post-acute resources. Provides coordination of services and acts as a key Liaison between patients, families and the interdisciplinary healthcare team members.
• Provides educational resources and/or referrals to patients and patients' families to address identified needs such as social or financial. Acts as an advocate for patients to resolve barriers to care progression.
• Discusses payer criteria and issues on a case by case basis with clinical staff and follows-up to resolve problems with payers as needed. Applies approved clinical criteria to monitor appropriateness of admissions, continued stays or post-acute setting appropriateness and documents findings based on department standards.
• Identifies at risk populations by using approved screening tools and following established reporting procedures. Monitors LOS and ancillary resource use, depending on inpatient stay or outpatient program criteria, on an ongoing basis and takes actions to achieve continuous improvement efficiencies in both areas.
• Participates in the assessment of patients' clinical and psychosocial needs through review of patient information, personal contact with patients/families and interdisciplinary healthcare team members. Communicates routinely with patients, families, interdisciplinary healthcare team members and other appropriate parties with regard to the status of patients' care plans and progress toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict resolution when necessary.

Benefits

• medical, dental and vision coverage
• a robust team member wellness program
• Inova matches the first 5% of eligible contributions – starting on your first day.
• up to $5,250 per year in education assistance
• up to $10,000 for student loans
• 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• paid time off
• paid parental leave
• flexible work schedules

What This Job Offers

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