RN Case Manager

St. Charles Health System•Bend, OR

11d

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, collaborating with the health care team to ensure appropriate use of resources. The position provides and oversees patient care 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 clients’ health and human service needs. Its work emphasizes advocacy, communication, resource management, and quality, cost-effective interventions and outcomes. For the Emergency Department assignment, the Case Manager screens and assesses patients and facilitates services that meet their health care needs while promoting quality and cost-effective outcomes. This includes identifying complex or high-utilization patients, assessing patients for case management and alternative community services, coordinating discharge planning, and supporting continuity of care.

Requirements

Graduate of an accredited school of nursing.
Current Oregon RN License.
AHA Basic Life Support for Healthcare Provider certification.
Three 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.

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

Apply the nursing process to assess patient conditions and needs, establish outcomes, implement appropriate nursing actions, and evaluate progress.
Use appropriate criteria and clinical information to determine medical necessity and appropriateness of continued stay.
Develop discharge plans with patients, families, and the health care team that reflect patient needs and available resources.
Collaborate with team members to support patient and family learning during the hospital stay and reinforce ongoing care through teaching or community referrals.
Coordinate and document discharge plans with physicians, hospital administration, patients and families, registered nurses, and other disciplines.
Support outcomes including reduced length of stay and cost per discharge, improved discharge procedures and patient satisfaction, and stronger interdisciplinary interactions.
Manage clinical aspects of discharge planning, including post-discharge parenteral and enteral needs, wound care, placement updates, medication procurement, primary care physician assignment, and complex discharge issues.
Identify potential barriers to discharge or transfer and communicate them to the care team to help resolve them.
Schedule and lead complex discharge rounds and conferences involving patients, families, and the interdisciplinary team as appropriate.
Facilitate patient care and act 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.
Help create a healing environment and intentional relationships, and provide a therapeutic presence through caring, effective communication and patient-centered interactions.
Maintain a safe environment for caregivers, patients, and guests; document patient care in compliance with organizational policies and regulatory requirements.
Support the organization’s vision, mission, values, continuous-improvement principles, and corporate integrity efforts; maintain professionalism and confidentiality.
Deliver timely, efficient, accurate customer service and patient care, and perform other duties of similar complexity as assigned.
For Emergency Department assignments, identify high-risk and high-utilization patients and patients who may benefit from case management, admission, alternative placements, or community services.
For Emergency Department assignments, coordinate discharge referrals and education, communicate with attending physicians about medical necessity and level of care, and notify hospital case management about admissions requiring follow-up.
For Emergency Department assignments, educate physicians on inpatient and observation medical necessity criteria.