RN Case Manager

Lifepoint Health • Danville, VA

1d • Onsite

About The Position

Sovah Health – Danville is part of Lifepoint Health, a nationally recognized healthcare network committed to making communities healthier®. We prioritize your well-being so you can deliver exceptional care to every patient. As a Registered Nurse, you’ll join a dedicated team where your skills, compassion, and clinical expertise make a direct and meaningful impact every day. Our Case Management team focuses on serving the adult population in our community, maintaining a patient-to-staff ratio that is below the national average. Our collaborative approach to safe, effective discharge planning includes close coordination between a Utilization Review RN, Case Manager RN, and Social Worker—ensuring each patient receives comprehensive, personalized support throughout their care journey.

Requirements

• Current VA RN license or compact state
• Experience in acute care hospital, preferred

Nice To Haves

• Bachelors degree preferred but not required

Responsibilities

• Completes documentation per workflow timeline and content requirements including completion of the Individual Plan of Care (IPoC) per CMS guidelines.
• Schedules family conferences and/or communicates with caregiver following each team conference and more often as needed to keep patient and designated caregiver informed of progress and provides appropriate information related to goal achievement, course of rehabilitation stay, and plans for discharge.
• Coordinates weekly patient care team conferences to facilitate development, monitoring and refinement of treatment plan to achieve identified patient goals and outcomes.
• Reviews the patient’s assigned CMG and helps the team identify any potential missed comorbid conditions that are actively being treated during the patient’s stay.
• Communicates any findings to the HIM team.
• Assists with concurrent and retrospective utilization review activities including denials and appeals.
• Works with physicians to conduct peer review with payer medical director when indicated.
• Ensures clinical updates are provided to all insurance payers when due and all payer communications are documented in Meditech.
• Coordinates discharge planning needs including but not limited to; home health services, physician follow up care, durable medical equipment, medical supplies, healthcare services, outpatient therapy, dialysis, skilled nursing care, assisted living care, hospice care, private duty care, etc.
• Responsible for coordinating all patient care needs prior to discharge ensuring a safe thorough discharge plan.
• Ensures patient choice is offered and documented as per CMS’ Conditions of Participation for Discharge Planning.
• Identifies trends that impact the quality, cost effectiveness, patient experience and delivery of care services and brings to departmental leadership meetings for discussion and action.
• Performs intake assessment on patient within 24 to 72 hours of admission, preferably within 48 hours.
• Performs follow-up assessments per Case Management Plan and/or hospital policy.
• Coordinates management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies.
• Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs.
• Serves as a patient advocate through resource utilization, discharge planning and addressing the holistic needs of the patient.

Benefits

• Multiple levels of medical, dental and vision coverage, tailored benefit options for part-time and PRN employees, and more.
• Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Ongoing learning and career advancement opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level