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

Bon Secours Mercy Health • Greenville, SC

20h • Onsite

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 and assesses patients’ health and related needs, plans and implements appropriate services, and evaluates available options, including social determinants that affect overall well-being. The RN Care Manager screens for and identifies individuals who need active case management and helps ensure the right resources are available at the right time and place.

The role works with patients, caregivers, and the healthcare team to plan care, monitor and revise plans as patients’ conditions change, document needs and plans, and coordinate transitions. Care planning incorporates patients’ and caregivers’ goals and preferences and addresses post-hospital needs and available resources. The RN Care Manager also supports advance care planning, length-of-stay management, readmission prevention, medical-necessity denial prevention, and timely testing and treatment.

Requirements

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

Nice To Haves

• Bachelor of Science in Nursing (preferred for Bon Secours Mercy Health; required for RSFH).
• At least 3 years of experience in an acute care clinical setting.
• Ambulatory or post-acute care coordination experience.
• 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.

Responsibilities

• Identify and prioritize patients needing care management through a holistic assessment of biopsychosocial, functional, cultural, spiritual, and financial factors.
• Plan care with patients, caregivers, and healthcare team members to maximize health outcomes, quality, and cost-effectiveness.
• Monitor patient conditions and revise care plans as indicated.
• Complete clear, concise, and timely documentation in patient records, including care needs, plans, post-hospital resources, and patient, family, or caregiver involvement.
• Use handovers during changes in level of care, staff changes, and care transitions.
• 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 medical-necessity denial prevention by addressing or removing barriers to progression of care and participating in interdisciplinary discharge rounds.
• Promote proactive patient care and help remove barriers to timely testing and treatment.
• Support appropriate resource utilization 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