Registered Nurse Senior- Case Management

Trinity Health • Silver Spring, MD

2d • $41 - $64 • Onsite

About The Position

The Registered Nurse Senior- Case Management implements case management activities for patients of all age groups to improve coordination of care, monitor and manage clinical resource use, ensure accurate clinical documentation, and provide continuity of care and post-hospital planning. The role helps optimize cost-efficient resource utilization and maximize reimbursement.

The nurse performs concurrent utilization reviews, documents clinical criteria and diagnoses, addresses level-of-care concerns with physicians, and coordinates referrals to the Physician Advisor. The role also uses the MIDAS automated review system and completes timely discharge-planning assessments. Effective communication with patients, families, and the health care team is essential.

Requirements

• Active RN license issued by the State of Maryland.
• At least three years of acute care experience.
• Knowledge of overall hospital operations, particularly reimbursement and regulatory matters.
• Strong written and verbal communication skills.
• Computer literacy and analytical skills.
• Ability to communicate effectively, with good audio and visual acuity.
• Demonstrated ability to work with patients of all ages, from birth through geriatric.

Nice To Haves

• Bachelor’s degree.
• Certification in Case Management.
• Experience in Utilization/Quality Management, Discharge Planning, and/or Clinical Documentation Enhancement.

Responsibilities

• Use InterQual criteria to concurrently review cases for appropriateness of admission and continued stay.
• Timely document Severity of Illness and Intensity of Service data in the URE module to support admission and continued stay.
• Interact with physicians about level-of-care concerns and facilitate transfers to a more appropriate level of care as needed.
• Refer cases to the Physician Advisor and initiate the advisor’s recommendations.
• Use implemented MIDAS automated review system modules correctly.
• Document concurrent primary and secondary diagnoses on admission review, every three days, and when the patient’s condition changes.
• Communicate with patients, their families when appropriate, and other members of the health care team.
• Complete thorough and timely initial discharge-planning documentation, including the Assessment Flow sheet and Plan of Care.

Benefits

• Comprehensive benefits, including medical, dental, vision, and mental health coverage.
• Paid time off.
• 403(b) plan.
• Education assistance.
• Voluntary benefits, including pet insurance, accident insurance, and hospital indemnity insurance.
• Flexible schedules.
• Free onsite parking.
• Referral Rewards Program.

What This Job Offers

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