Registered Nurse (RN) - Care Manager - Mary Immaculate Hospital
About The Position
The RN Care Manager coordinates patient care to support safe, seamless, and timely transitions across the continuum. Using a collaborative process and quantitative and qualitative methods, the role identifies and assesses patients’ health and health-related needs, plans and implements appropriate services, and evaluates available options, including social determinants that affect overall well-being. The RN Care Manager screens for and identifies individuals who need active case management and helps connect them with appropriate resources at the right time and place. The position works with patients, caregivers, and the healthcare team to plan care, monitor changes in patient condition, and support quality and cost-effective outcomes. It maintains timely documentation, supports transition planning and communication across the multidisciplinary team, and follows standardized practices for advance care planning, length-of-stay management, and readmission prevention. The role also supports medical-necessity denial prevention, helps remove barriers to timely testing and treatment, and promotes appropriate use of resources and alternatives to acute care.
Requirements
- At least 1 year of experience in a clinical setting.
- RN license in the state of employment or coverage by a compact license.
- BLS Basic Life Support certification from the American Heart Association.
- Skills in care management, discharge planning, patient advocacy, flexible care planning, and care coordination.
- Ability to analyze data or information and working knowledge of reimbursement methodologies, staffing workflow, and bed allocation.
- Clinical knowledge and ability to track information.
- Working knowledge of local and state resources and knowledge of government and non-government payer practices, regulations, standards, and reimbursement.
- Interpersonal skills including knowledge sharing, attention to detail, critical thinking, communication with family members, conflict resolution, proactive problem-solving, active listening, relationship building, effective problem-solving, teamwork, and facilitation.
Nice To Haves
- Bachelor of Science in Nursing (preferred for Bon Secours; required for RSFH).
- Accredited Case Manager (ACM) certification from the American Case Management Association, Certified Case Manager (CCM) certification from the Commission for Case Manager Certification, or ANCC Nursing Case Management board certification.
- At least 3 years of experience in an acute care clinical setting.
- Ambulatory or post-acute care coordination experience.
Responsibilities
- Identify and prioritize patients needing care management using a holistic approach that considers biopsychosocial, functional, cultural, spiritual, and financial factors.
- Plan with patients, caregivers, and healthcare team members to maximize healthcare responses and achieve quality, cost-effective outcomes.
- Monitor and revise care plans when a patient’s condition changes.
- Complete necessary documentation and maintain clear, concise, and timely records reflecting patient needs.
- Use handovers when levels of care or staff change and during care transitions.
- Document post-hospital care plans and resources, including evidence of patient, family, or caregiver involvement.
- Ensure patients’ and caregivers’ treatment goals and preferences are incorporated into transition planning and communicated to the multidisciplinary team.
- Follow standardized practices and processes for advance care planning, length-of-stay management, and readmission prevention.
- Support medical-necessity denial prevention by addressing or removing barriers to care progression and participating in interdisciplinary discharge rounds.
- Promote proactive care and help remove barriers to timely testing and treatment.
- Ensure resources are used appropriately and offer alternatives to acute care to the care team.
Benefits
- Competitive pay, incentives, and referral bonuses.
- 403(b) with employer contributions when eligible.
- Medical, dental, vision, and prescription coverage.
- HSA/FSA options and 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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
