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 RN Care Manager identifies, assesses, plans, implements, and evaluates options and services needed to meet patients’ health and health-related needs, including social determinants that affect overall well-being. The role screens, identifies, and assesses individuals who need active case management services and promotes access to the right resources at the right time and place. The position involves holistic care planning with patients, caregivers, and healthcare team members; monitoring and revising plans as conditions change; maintaining timely and clear documentation; coordinating care transitions; and supporting advance care planning, length-of-stay management, readmission prevention, medical-necessity denial prevention, and timely testing and treatment. The RN Care Manager also helps identify appropriate resource use and alternatives to acute care.
Requirements
- Bachelor of Science in Nursing preferred for Bon Secours Mercy Health; required for RSFH.
- Current RN license in the state of employment or a compact-covered license.
- Basic Life Support (BLS) certification from the American Heart Association.
- At least 1 year of experience in a clinical setting.
- Skills in care management, discharge planning, patient advocacy, care planning, care coordination, data analysis, reimbursement methodologies, staffing workflow and bed allocation, clinical knowledge, tracking, and knowledge of local and state resources.
- Working knowledge 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, proactivity, problem solving, active listening, relationship building, teamwork, and facilitation.
Nice To Haves
- Bachelor of Science in Nursing (preferred for Bon Secours Mercy Health).
- 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 needing care management services, considering biopsychosocial, functional, cultural, spiritual, and financial factors.
- Plan with patients, caregivers, and healthcare team members to support effective care, quality, and cost-effective outcomes.
- Monitor and revise care plans when patient conditions change.
- 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 needs, available resources, and 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 medical-necessity denial prevention 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.
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.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
