RN Care Mgr II

Covenant Health•Knoxville, TN

3d•Onsite

About The Position

The RN Care Manager II integrates evidence-based clinical practice into patient care, coordinates education for staff and patients, and serves as a clinical resource and consultant to the healthcare team. The role promotes patient care coordination and quality by collaborating on practice guidelines and clinical pathways that support quality improvement, and seeks research to identify best practices. The position is accountable for comprehensive care coordination, including planning, implementing, monitoring, and evaluating care outcomes for a designated patient population. The RN Care Manager II is part of the nursing unit leadership team and reports directly to the facility Manager/Coordinator of Quality and Care Management. The position assesses patient needs, develops and revises care management plans, coordinates multidisciplinary resources, and supports efficient and timely care. It works with patients, families, physicians, nursing, and other healthcare professionals on treatment, education, documentation, and transitions to the appropriate next level of care. The role also monitors care outcomes and regulatory requirements, supports quality improvement and cost-containment efforts, advocates for patients, and contributes to staff education and leadership activities. The position requires a bachelor’s degree in Nursing or a related field, or a qualifying certification as described in the qualifications. Candidates must have four years of Registered Nurse experience, including at least three years in the assigned area of responsibility, a current Tennessee RN license, and current certification in Case Management (CCM or ACM) or CPHQ, unless meeting the stated bachelor’s degree alternative.

Requirements

Bachelor’s degree in Nursing or a related field, or a qualifying certification listed in the posting.
At least four years of experience as a Registered Nurse.
At least three years of experience in the area of assigned responsibility.
Current Tennessee RN license.
Current certification in Case Management (CCM or ACM) or CPHQ, or a bachelor’s degree in Nursing or a related field.

Responsibilities

Screen patients using case-finding criteria and gather information from medical records, physicians, patients, families, and other sources to develop comprehensive care plans.
Review clinical documentation with Clinical Documentation Improvement specialists as needed and evaluate patients’ daily progress toward care objectives.
Modify care management plans as patients’ clinical conditions and needs change, securing resources through multidisciplinary coordination.
Research, design, and implement practice guidelines and clinical care designs with physicians, nursing, and other healthcare team members.
Set goals and actions to meet identified patient needs and communicate with the healthcare team to plan and implement care.
Visit patients and provide education on medications, treatment plans, discharge instructions, and care modalities.
Participate in daily multidisciplinary rounds and ensure appropriate disciplines are involved.
Collaborate with Nurse Managers on sound clinical practices and the development of staff or patient education activities.
Coordinate with physicians, healthcare providers, facilities, agencies, and third-party payers to support appropriate, efficient, and cost-effective care.
Document care management activities, patient goals, and transition plans in the medical record and serve as a liaison among patients, families, physicians, and the healthcare team.
Organize, secure, integrate, and document resources needed to accomplish discharge-plan goals, including arranging coverage for community services when necessary.
Monitor the effectiveness of care management plans, coordinate transitions to the appropriate next level of care, and identify and address variances in the care process.
Stay informed about quality requirements and regulatory measures, and monitor for potential healthcare-acquired conditions and hospital-acquired infections.
Coordinate discharge and transition planning, including multidisciplinary bedside rounds, and revise plans as patient needs change.
Measure clinical and fiscal variances, communicate outcomes, recommend performance-improvement opportunities, and support cost containment.
Identify causes of outcome variances, implement and evaluate corrective actions, research best practices, and participate in quality-improvement initiatives.
Address end-of-life issues with physicians, families, and other healthcare team members, while maintaining patient privacy.
Advocate for patients and provide care management services within the registered nurse scope of practice and applicable legal and regulatory standards.
Research, plan, develop, and assist with patient education, using return demonstrations to confirm patient and family understanding.
Participate in staff development, orientation, unit meetings, mentoring, consultation, educational presentations, and clinical direction.
Participate in hiring, supervision, education, orientation, evaluation, and discipline of staff.
Follow policies, procedures, and safety standards; complete annual education assignments; and work toward goals and quality-improvement objectives.