RN Case Manager - Weekends

Carilion Clinic•Roanoke, VA

8d•Onsite

About The Position

The RN Case Manager provides case management for assigned patient populations. Utilizes clinical expertise, communication and problem solving skills to achieve optimal clinical and resource outcomes. Promotes cost-effective care by minimizing fragmentation, maximizing coordination, and facilitating patient/family movement through the health care organization. Performs patient needs assessments upon admission and at regular intervals; facilitating referrals and providing linkages to health, wellness, and post-acute care resources across the health care continuum. The RN Case Manager Provides care management for assigned patient populations, utilizing clinical expertise, communication, and problem-solving skills to achieve optimal clinical and resource outcomes. Performs patient needs assessments upon admission and at regular intervals to support care planning, discharge planning, and transitions across the continuum of care. Facilitates safe and effective transitions of care, including coordination of post-acute services such as home health, hospice, and durable medical equipment. Promotes interdisciplinary collaboration with physicians, nursing, social work, utilization review, and other care team members to ensure alignment of the plan of care and discharge plan. Ensures appropriate utilization of resources, length of stay management, and compliance with regulatory and payer requirements. Collaborates with Utilization Review to ensure accurate patient status and medical necessity using tools such as InterQual. Coordinates with patients and families to ensure understanding of discharge plans, including financial implications and available resources. Ensures documentation accurately reflects patient condition, comorbidities, treatment, and interventions in accordance with regulatory and organizational standards. Coordinates referrals and authorizations for medications, services, and post-acute care needs to prevent discharge delays. Facilitates communication and coordination for patient transfers, including acute-to-acute transitions and transitions involving correctional facilities. Identifies and addresses barriers to discharge and implements appropriate interventions. Participates in interdisciplinary team meetings and contributes to care progression and discharge planning discussions. Maintains effective communication with all disciplines to support timely and appropriate patient care transitions. Engages in performance improvement initiatives and utilizes predictive analytics tools to support patient outcomes and reduce readmissions. Collects and analyzes patient care and utilization data to support quality and fiscal outcomes. Advocates for patients and families throughout the episode of care.

Requirements

Bachelor’s degree required.
5 years Case Management experience in a hospital setting may be considered in lieu of a Bachelor’s degree
3 years of recent experience in a clinical health care setting with responsibilities reflecting direct management of patient care including planning, coordination, and delivery of needed services such as education, psychosocial support, discharge planning and utilization management.
Current Registered Nurse License in the State of Virginia required.

Nice To Haves

Supervisory or leadership experience is preferred

Responsibilities

Provides case management for assigned patient populations.
Utilizes clinical expertise, communication and problem solving skills to achieve optimal clinical and resource outcomes.
Promotes cost-effective care by minimizing fragmentation, maximizing coordination, and facilitating patient/family movement through the health care organization.
Performs patient needs assessments upon admission and at regular intervals.
Facilitates referrals and providing linkages to health, wellness, and post-acute care resources across the health care continuum.
Performs patient needs assessments upon admission and at regular intervals to support care planning, discharge planning, and transitions across the continuum of care.
Facilitates safe and effective transitions of care, including coordination of post-acute services such as home health, hospice, and durable medical equipment.
Promotes interdisciplinary collaboration with physicians, nursing, social work, utilization review, and other care team members to ensure alignment of the plan of care and discharge plan.
Ensures appropriate utilization of resources, length of stay management, and compliance with regulatory and payer requirements.
Collaborates with Utilization Review to ensure accurate patient status and medical necessity using tools such as InterQual.
Coordinates with patients and families to ensure understanding of discharge plans, including financial implications and available resources.
Ensures documentation accurately reflects patient condition, comorbidities, treatment, and interventions in accordance with regulatory and organizational standards.
Coordinates referrals and authorizations for medications, services, and post-acute care needs to prevent discharge delays.
Facilitates communication and coordination for patient transfers, including acute-to-acute transitions and transitions involving correctional facilities.
Identifies and addresses barriers to discharge and implements appropriate interventions.
Participates in interdisciplinary team meetings and contributes to care progression and discharge planning discussions.
Maintains effective communication with all disciplines to support timely and appropriate patient care transitions.
Engages in performance improvement initiatives and utilizes predictive analytics tools to support patient outcomes and reduce readmissions.
Collects and analyzes patient care and utilization data to support quality and fiscal outcomes.
Advocates for patients and families throughout the episode of care.