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 patients in an assigned caseload and collaborates with the health care team to support appropriate use of resources. The position provides and oversees nursing care for assigned patients during the shift within the scope of RN licensure and does not directly manage other caregivers. The Case Management Department assesses, plans, implements, coordinates, monitors, and evaluates services needed to meet patients’ health and human service needs. Its work emphasizes advocacy, communication, and resource management to promote quality, cost-effective interventions and outcomes. The RN Case Manager assesses patient needs, confirms medical necessity for continued stay, and develops discharge plans with patients, families, and the health care team. The role supports patient and family education, coordinates clinical discharge needs and community referrals, identifies barriers to discharge, and contributes to quality improvement and patient-care outcomes. The position may provide cross-coverage for other units and St. Charles locations and may involve occasional travel for education, meetings, or training. For an RN Case Manager assigned to the Emergency Department, additional duties include screening and assessing patients for case management, with emphasis on high-risk, high-utilization, potential-admission, and alternative-placement populations. The ED Case Manager coordinates discharge planning, connects patients and families with community resources, communicates with attending physicians about medical necessity and level of care, alerts hospital case management about admissions needing follow-up, and educates physicians on inpatient and observation medical necessity criteria.

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 appropriate personal protective equipment required to perform the job safely.
Ability to use a clear and audible speaking voice and hear normal speech levels.
Ability to perform the stated physical activities, including sitting, keyboard operation, occasional standing, walking, bending, stooping, kneeling, crouching, stair climbing, overhead reaching, and handling objects weighing 1–10 pounds.

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 using the nursing process, identify needs and outcomes, implement appropriate nursing actions, and evaluate progress.
Use appropriate criteria and clinical information to determine medical necessity for continued stay and evaluate continued-stay appropriateness.
Develop discharge plans with patients, families, and the health care team that reflect patient needs and available resources.
Support patient and family learning during the hospital stay and reinforce continuing care through education and referrals to community agencies.
Coordinate and document discharge plans with physicians, administration, nurses, patients, families, and other disciplines.
Manage clinical discharge-planning needs, including post-discharge parenteral and enteral needs, wound-vac and complex wound care, placement updates, medication procurement for an initial 30-day need, primary care physician assignment, and complex discharge issues.
Identify barriers to discharge or transfer, communicate them to the care team, and help resolve them.
Schedule and lead complex discharge rounds and conferences with patients, families, and interdisciplinary teams as appropriate.
Facilitate patient care and serve as a liaison to internal services and external agencies.
Facilitate staff education and participate in quality-improvement and evaluation processes related to case management.
Provide cross-coverage for other units and, as needed, other St. Charles sites.
Contribute to a healing environment and intentional relationships, providing a caring therapeutic presence and communicating effectively with patients.
Maintain a safe environment for caregivers, patients, and guests; use required personal protective equipment.
Document patient care in compliance with hospital policies, procedures, and regulatory requirements.
Support the organization’s vision, mission, and values; champion continuous improvement and Value Improvement Practice (VIP-Lean) principles.
Conduct work professionally and confidentially, comply with applicable laws and policies, report suspected violations, and cooperate with organizational investigations.
Provide timely, efficient, accurate customer service and patient care; perform other similar duties as assigned.
For Emergency Department assignment, identify complex and high-utilization patients and screen ED patients for case-management needs, especially high-risk or target populations, potential hospital admissions, and patients whose needs may be met through community placements or services.
For Emergency Department assignment, provide referrals and education about community resources, communicate with attending physicians about medical necessity and level of care, notify hospital case management of admissions needing follow-up, and educate physicians on inpatient and observation medical necessity criteria.