Registered Nurse (RN) - Care Manager - St. Francis Downtown

Bon Secours Mercy Health•Greenville, SC

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 the options and services needed to address patients’ health and health-related needs, including social determinants of well-being. The RN Care Manager screens and assesses individuals who may need active case management and helps ensure they receive appropriate resources at the right time and place. The position works with patients, caregivers, and the healthcare team to plan and coordinate care, monitor changing needs, support transitions, and promote appropriate resource use. It includes maintaining timely patient-record documentation, supporting discharge planning and length-of-stay management, helping prevent readmissions and denials, and removing barriers to timely testing and treatment.

Requirements

Bachelor of Science in Nursing (required for RSFH; preferred for BSMH).
BLS Basic Life Support certification from the American Heart Association.
RN license in the state where the employee is working or coverage under a compact license.
At least 1 year of experience in a clinical setting.
Skills in care management, discharge planning, patient advocacy, flexible care planning, and care coordination.
Ability to analyze data or information; knowledge of reimbursement methodologies, staffing workflow and bed allocation, and clinical practices.
Working knowledge of local and state resources and of government and non-government payor 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, teamwork, and facilitation.

Nice To Haves

Bachelor of Science in Nursing (preferred for BSMH).
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, considering biopsychosocial, functional, cultural, spiritual, and financial factors.
Plan with patients, caregivers, and healthcare-team members to support effective care and quality, cost-effective outcomes.
Monitor and revise care plans when a patient’s condition changes.
Complete necessary documentation and maintain clear, concise, timely records of patient needs and care plans.
Use handovers when the level of care or staff changes and during care transitions.
Document post-hospital care needs and resources, including patient, family, or caregiver involvement in planning.
Ensure patient and caregiver treatment goals and preferences are included in transition planning and communicated 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 resource use and offer alternatives to acute care to the care team.