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Registered Nurse (RN) - Care Manager - Mary Immaculate Hospital - PRN

Bon Secours Mercy Health•Newport News, VA
•$39 - $62

About The Position

The RN Care Manager coordinates patient care to support safe, seamless, and timely transitions across the continuum. Using a collaborative process, the RN Care Manager identifies, assesses, plans, implements, and evaluates options and services needed to meet patients’ health and health-related needs, including social determinants that affect overall well-being. The role screens, identifies, and assesses individuals who need active case management services and promotes access to the right resources at the right time and place. The RN Care Manager uses a holistic approach that considers biopsychosocial, functional, cultural, spiritual, and financial factors. The position collaborates with patients, caregivers, and healthcare team members to maximize quality and cost-effective outcomes, monitors and revises care plans as conditions change, maintains timely and clear documentation, and supports care transitions, discharge planning, utilization of resources, and prevention of denials and readmissions.

Requirements

  • Bachelor of Science in Nursing preferred for BSMH and required for RSFH.
  • Current RN license in the state of employment or covered by a compact license.
  • BLS Basic Life Support certification from the American Heart Association.
  • At least 1 year of experience in a clinical setting.
  • Skills in care management, discharge planning, patient advocacy, care planning, care coordination, data analysis, reimbursement methodologies, staffing workflow and bed allocation, clinical knowledge, tracking, and knowledge of local and state resources.
  • Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
  • Interpersonal skills including knowledge sharing, attention to detail, critical thinking, communication with family members, conflict resolution, proactivity, problem solving, active listening, relationship building, teamwork, and facilitation.

Nice To Haves

  • Bachelor of Science in Nursing for BSMH applicants.
  • Accredited Case Manager (ACM) certification from the American Case Management Association, Certified Case Manager (CCM) certification from the Commission for Case Manager Certification, or ANCC Nursing Case Management board certification.
  • At least 3 years of experience in an acute care clinical setting.
  • Ambulatory or post-acute care coordination experience.

Responsibilities

  • Identify and prioritize patients needing care management services, considering biopsychosocial, functional, cultural, spiritual, and financial factors.
  • Plan with patients, caregivers, and healthcare team members to maximize healthcare responses, quality, and cost-effective outcomes.
  • Monitor care plans and revise them as indicated when a patient's condition changes.
  • Complete necessary documentation and maintain clear, concise, and timely documentation in patient records.
  • Use handovers at changes in level of care, staff changes, and care transitions.
  • Document post-hospital care needs, resources, and involvement of patients, families, or caregivers in care planning.
  • Ensure patients’ and caregivers’ treatment goals and preferences are incorporated into transition planning and communicated to the multidisciplinary team.
  • Follow standardized practices and processes for advance care planning, length-of-stay management, and readmission prevention.
  • Support denial prevention related to medical necessity by addressing or removing barriers to progression of care and participating in interdisciplinary discharge rounds.
  • Promote proactive care and assist in removing barriers to timely testing and treatment.
  • Ensure appropriate resource utilization and offer alternatives to acute care to the care team.

Benefits

  • Competitive pay, incentives, referral bonuses, and 403(b) with employer contributions when eligible.
  • Medical, dental, vision, and prescription coverage; HSA/FSA options; life insurance; mental health resources; and discounts.
  • Paid time off, parental and FMLA leave, short- and long-term disability, and backup care for children and elders.
  • Tuition assistance, professional development, and continuing education support.

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