Registered Nurse (RN) - Care Manager - Anderson Hospital

Mercy Health • Cincinnati, OH

18h

About The Position

The RN Care Manager coordinates patient care to support safe, seamless, and timely transitions across the continuum of care. Using a collaborative process and quantitative and qualitative methods, the role identifies, assesses, plans, implements, and evaluates services and options to meet patients’ health and health-related needs, including social determinants affecting overall well-being. The RN Care Manager screens for and identifies people 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, respond to changes in patient condition, and support quality and cost-effective outcomes. It documents patient needs and care plans, including post-hospital needs, available resources, and patient and caregiver involvement. The role also supports advance care planning, length-of-stay management, readmission prevention, medical-necessity denial prevention, and timely testing and treatment.

Requirements

• BLS Basic Life Support certification from the American Heart Association.
• RN license in the state of work or licensure covered by a compact.
• At least 1 year of experience in a clinical setting.
• Skills and knowledge in care management, discharge planning, patient advocacy, care planning, and care coordination.
• Ability to analyze data or information and knowledge of reimbursement methodologies, staffing workflow, and bed allocation.
• Clinical knowledge, tracking skills, and working knowledge of local and state resources.
• Knowledge of government and non-government payer practices, regulations, standards, and reimbursement.
• Interpersonal skills including knowledge sharing, attention to detail, critical thinking, family communication, conflict resolution, proactive 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.
• 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, considering 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 clear, concise, and timely documentation 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, patient and caregiver involvement, and treatment goals and preferences.
• Communicate patient and caregiver goals and preferences to the multidisciplinary team during transition planning.
• Follow standardized practices and processes for advance care planning, length-of-stay management, and readmission prevention.
• Support medical-necessity denial prevention by addressing 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.

Benefits

• Competitive pay, incentives, referral bonuses, and a 403(b) with employer contributions when eligible.
• Medical, dental, vision, and prescription coverage; HSA/FSA options; 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed