RN Case Manager

St. Charles Health System•Bend, OR

12d

About The Position

The RN Case Manager provides clinically based case management to support effective and efficient patient care. The role is accountable for utilization management and discharge planning for an assigned caseload, collaborates with the health care team to identify appropriate use of resources, and provides and oversees nursing care consistent with the scope of RN licensure. The position does not directly manage other caregivers. The Case Management Department assesses, plans, implements, coordinates, monitors, and evaluates services to meet clients’ health and human service needs. Its work emphasizes advocacy, communication, resource management, quality, and cost-effective outcomes. For an RN Case Manager assigned to the Emergency Department, additional duties include identifying complex or high-utilization patients, screening patients for case management needs, coordinating discharge planning and community referrals, communicating about medical necessity and level of care, notifying hospital case management of admissions needing follow-up, and educating physicians on inpatient and observation medical-necessity criteria. The position is regular, non-exempt, and scheduled for 40 hours weekly with variable days and shifts. The listed shift hours are 8:00–16:30. Occasional travel to community locations, other St. Charles sites, or regional locations may be required for education, meetings, or training.

Requirements

Graduate of an accredited school of nursing.
Current Oregon RN license.
AHA Basic Life Support for Healthcare Provider certification.
At least 3 years of clinical nursing experience in an acute care setting.
Knowledge of quality improvement.
Previous experience emphasizing disease management and patient and staff education.
Ability to wear the personal protective equipment required to perform the job safely.

Nice To Haves

Bachelor of Science in Nursing (BSN).
Certification in Case Management.
Experience in case management and/or discharge planning.
Specialty experience such as cardiac, emergency department, oncology, orthopedics, or neuroscience.

Responsibilities

Assess patients’ conditions and needs; establish outcomes; plan and implement nursing actions; and evaluate patient progress using the nursing process.
Use appropriate criteria to confirm medical necessity for continued stay and evaluate appropriateness of continued stay using clinical information and screening criteria.
Develop discharge plans with patients, families, and the health care team that reflect patient needs and available resources.
Facilitate patient and family learning during the hospital stay, reinforce ongoing health care through teaching, and refer patients to community follow-up resources.
Partner with physicians, hospital administration, patients and families, nurses, and other disciplines to implement and document discharge plans and support continuity of care.
Manage clinical discharge-planning needs, including post-discharge parenteral and enteral needs, wound and wound-vac care, clinical updates for placement, medication procurement for the initial 30-day need, primary care physician assignment, and complex discharge issues.
Identify potential barriers to discharge or transfer, communicate them to the care team, and help resolve them.
Schedule and lead complex patient discharge rounds and conferences involving patients, families, and the interdisciplinary team as appropriate.
Act as a patient-care facilitator and liaison to internal services and external agencies.
Facilitate staff education and participate in quality improvement and evaluation related to case management practice.
Provide cross-coverage for other units and, as needed, other St. Charles sites.
Contribute to a healing environment, intentional relationships, and a positive care experience; respond therapeutically and compassionately to patient needs.
Maintain a safe environment for caregivers, patients, and guests; document patient care in accordance with hospital policies, procedures, and regulatory requirements.
Support the organization’s vision, mission, values, and continuous-improvement principles; conduct work professionally, ethically, and confidentially; and provide timely, efficient, accurate customer service and patient care.
Perform additional duties of similar complexity as required or assigned.
For Emergency Department assignments, identify complex and high-utilization patients appropriate for case management and screen patients, with emphasis on high-risk or target populations, potential admissions, and patients who may benefit from alternative placements or community services.
For Emergency Department assignments, provide appropriate community-resource referrals and education to patients and families; communicate with attending physicians about medical necessity and level of care; and notify hospital case management of admissions requiring follow-up.
For Emergency Department assignments, serve as a resource and educate physicians on inpatient and observation medical-necessity criteria.