Registered Nurse (RN) - Care Manager - Fairfield Hospital

Mercy Health BSMH•Fairfield, OH

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, assesses, plans, implements, and evaluates options and services addressing patients’ health and related needs, including social determinants that affect overall well-being. The RN Care Manager screens for and identifies people who need active case management and promotes access to appropriate resources at the right time and place. The role uses a holistic approach to prioritize patients, considering biopsychosocial, functional, cultural, spiritual, and financial factors. The RN Care Manager plans with patients, caregivers, and the healthcare team to support quality, effective, and cost-conscious outcomes, and monitors and revises care plans as conditions change. The position also documents patient needs and care plans, supports discharge and transition planning, and works with the multidisciplinary team to address barriers to timely care and appropriate resource use.

Requirements

Bachelor of Science in Nursing.
Current RN license in the state where the associate works or a license covered by a compact agreement.
Basic Life Support (BLS) certification from the American Heart Association.
At least 1 year of experience in a clinical setting.
Skills and knowledge in care management, discharge planning, patient advocacy, care planning, care coordination, clinical knowledge, data analysis, reimbursement methodologies, staffing workflow and bed allocation, tracking, and local and state resources.
Working knowledge of government and non-government payer practices, regulations, standards, and reimbursement.
Interpersonal abilities including knowledge sharing, attention to detail, critical thinking, communication with family members, conflict resolution, proactivity, problem solving, active listening, relationship building, teamwork, and facilitation.

Nice To Haves

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.
3 years of experience in an acute care clinical setting.
Ambulatory or post-acute care coordination experience.

Responsibilities

Identify and prioritize patients who need care management services using a holistic assessment of biopsychosocial, functional, cultural, spiritual, and financial factors.
Plan care with patients, caregivers, and healthcare team members to maximize health care responses and achieve quality, cost-effective outcomes.
Monitor patient status and revise care plans when patient conditions change.
Complete necessary documentation and maintain clear, concise, and timely patient records.
Use handovers when the level of care or staff changes and during care transitions.
Document post-hospital care needs and resources, and evidence of patient, family, or caregiver participation in planning.
Incorporate patients’ and caregivers’ treatment goals and preferences into transition planning and communicate them to the multidisciplinary team.
Follow standardized practices for advance care planning, length-of-stay management, and readmission prevention.
Support denial prevention related to medical necessity by addressing or removing barriers to progression of care and participating in interdisciplinary discharge rounds.
Promote proactive care and help remove barriers to timely testing and treatment.
Ensure appropriate use of resources and offer alternatives to acute care to the care team.