RN-Nurse Case Manager

Trinity Health•Dubuque, IA

1d•Onsite

About The Position

The Care Manager RN supports safe, high-quality patient care by coordinating clinical and discharge planning activities across the continuum. This role integrates clinical expertise, patient advocacy, and collaboration with providers and interdisciplinary teams to ensure timely progression of care, optimize length of stay, and support transitions consistent with regulatory, payer, and organizational standards. Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Professional Nursing Practice: Acts independently & appropriately within license, scope of knowledge & experience in practice area; Continues to evolve with best evidence discoveries; Provides leadership & retains accountability for delegation, choices, decisions & outcomes; Collaborates with key stakeholders & contributes to quality & improvement practices & outcomes; Exhibits willingness to take on new & additional responsibilities; Embraces new ideas & cultural differences while managing competing priorities. Professional Nursing Process (ANA): Knows, understands, incorporates & demonstrates (document, teach, coordinate, advocate) standard elements of professional practice: Assess, Diagnose, Outcomes Identification / Solutions, Plan, Implement, Evaluate. Professional Development: Participates in own professional development by maintaining required competencies, licenses & certifications, identifying learning needs & seeking appropriate assistance or educational offerings; Supports the learning & development of others (e.g., staff, formal learners, patients, families, community). Compassion, Communication & Stewardship: Incorporates caring process (Caritas), advocacy & appropriate resource utilization as an essential component of nursing practice through concrete acts, interpersonal relationships & effective & respectful written, verbal & nonverbal communications. Environment of Care: Practices in an environmentally safe, professional manner; monitors & initiates corrections or evidence-based practices, including those for equipment & material resources; Promotes optimum physical & psychological behaviors; Influences effective, judicious & financially responsible use of resources. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.

Requirements

Graduate from an accredited school of nursing required.
Current Iowa RN license
Proof of completion of Mandatory Reporter – Child and/or Dependent Adult Abuse training within three (3) months of hire.
Three (3) years of nursing or care coordination experience required.

Nice To Haves

Bachelor of Science in Nursing (BSN) is preferred.

Responsibilities

Conduct comprehensive assessments to identify medical, psychosocial, and discharge needs upon admission and throughout the stay.
Collaborate with physicians and the care team to develop, implement, and modify individualized care plans.
Lead daily progression-of-care rounds to identify barriers and ensure timely movement through the care continuum.
Coordinate discharge planning, including patient/family education, post-acute placement, home services, and follow-up appointments.
Communicate clinical information to payers as needed and collaborate with Utilization Review on authorization and continued stay needs.
Identify patients with complex needs and engage Social Work for psychosocial, behavioral health, guardianship, or community resource support.
Monitor length of stay, avoidable delays, readmission risks, and patient flows; escalate barriers as appropriate.
Facilitate safe and appropriate transitions between care settings, ensuring handoffs are accurate and timely.
Promote patient advocacy by ensuring understanding of plan of care, goals, and discharge expectations.
Maintain documentation in accordance with regulatory, payer, and organizational requirements.
Participate in performance improvement, readmission reduction, and throughput initiatives.
Serve as a clinical resource to patients, families, and the interdisciplinary team on care transitions and community options.
Onboards, orients, and mentors new staff.
Provides support to Patient Logistics RNs and clinical partners on level-of-care appropriateness, medical necessity and continued stay criteria, and applicable regulatory and payer requirements.
Provides advanced case management support for complex or high-risk transfer cases, including early identification of discharge barriers for patients transferring from outside facilities.
Evaluates escalated and complex cases that fall outside established criteria and delivers clinical consultation to identify documentation gaps, develop effective escalation strategies, and facilitate coordination with physician advisors, Acute Care Management leadership, and payers.