Registered Nurse (RN) - Care Manager - Anderson Hospital

Mercy Health BSMH•Amberley, OH

18h

About The Position

The RN Care Manager coordinates patient care to support safe, seamless, and timely transitions across the continuum. Using a collaborative process, the role identifies, assesses, plans, implements, and evaluates services and options needed to meet patients’ health and related needs, including social determinants that affect overall well-being. The RN Care Manager screens, identifies, and assesses people who need active case management and promotes access to the right resources at the right time and place. The position uses a holistic approach that considers biopsychosocial, functional, cultural, spiritual, and financial factors. It works with patients, caregivers, and the healthcare team to support quality, cost-effective outcomes, and adapts care plans as patient conditions change. The role documents patient needs and care plans, coordinates transitions, supports advance care planning and length-of-stay management, helps prevent readmissions and medical-necessity denials, and works to remove barriers to timely testing and treatment.

Requirements

Current RN license in the state of employment or covered by a compact license.
Basic Life Support (BLS) certification from the American Heart Association.
At least 1 year of experience in a clinical setting.
Care management, discharge planning, patient advocacy, care planning, and care coordination skills.
Ability to analyze data or information and track care-related activity.
Knowledge of reimbursement methodologies, staffing workflow, and bed allocation.
Clinical knowledge and working knowledge of local and state resources.
Knowledge of government and non-government payer practices, regulations, standards, and reimbursement.
Knowledge sharing, attention to detail, critical thinking, and communication with family members.
Conflict resolution, proactive problem solving, active listening, relationship building, teamwork, and facilitation skills.

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.
At least 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 approach.
Plan care with patients, caregivers, and healthcare team members to maximize healthcare responses and achieve quality, cost-effective outcomes.
Monitor 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 plans for post-hospital care needs and resources, including evidence of patient, family, or caregiver involvement.
Incorporate patient and caregiver treatment goals and preferences into transition planning and communicate them to the multidisciplinary team.
Follow standardized practices and processes 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 resource use and offer alternatives to acute care to the care team.