RN Case Manager - Weekends - Full time

EMPLOYMENT STATUS

Full time

SHIFT

Weekends Only (United States of America)

FACILITY

1906 Belleview Ave SE - Roanoke

REQUISITION NUMBER

R160315 RN Case Manager - Weekends - Full time (Open)

HOW YOU’LL HELP TRANSFORM HEALTHCARE

Sign on bonus and relocation assistance available

Three 12 hour shifts: Thursday, Friday, Saturday, 7am-7pm

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.  Promotes interdisciplinary
collaboration and teamwork to progress the plan of care and discharge plan. 
Promotes appropriate length of stay, resource management, and care transitions
to the next level of care.  Must comply with all federal and state regulations
surrounding the discharge process. Must possess knowledge of growth and
development appropriate to age group served and incorporate plan to meet needs
into plan of care.

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.  Promotes interdisciplinary
collaboration and teamwork to progress the plan of care and discharge plan. 
Promotes appropriate length of stay, resource management, and care transitions
to the next level of care.  Must comply with all federal and state regulations
surrounding the discharge process. Must possess knowledge of growth and
development appropriate to age group served and incorporate plan to meet needs
into plan of care.

* Collaborates with Utilization Review Nurse.
* Maintains regular contact with assigned Utilization Review Nurse throughout
the day.
* Uses InterQual software to support accurate patient statuses according to
ongoing medical necessity.
* Aids in the delivery of regulatory letters and patient notices related to
insurance coverage/non-coverage, using support staff as appropriate.
* Ensures documentation accurately reflects the patient’s condition,
co-morbidities, treatment and procedures that support the most appropriate
admission status and DRG assignment.
* Communicates with patients/families to ensure understanding financial
implications of discharge plans
* Facilitates an interdisciplinary approach to patient care.
* Actively participates in Interdisciplinary Team Meetings on assigned units,
sharing meaningful and professional knowledge to the team discussion
regarding progression of care.
* Provides feedback to the health care team verbally and via chart entries
regarding the patient's progress toward reaching expected outcomes or about
barriers to the plan.  Manages changes to the plan as necessary.
*   Maintains effective communications with all disciplines to promote timely
and appropriate discharges.
* Daily communication with Social Work and Utilization Review: includes case
reviews, morning touchpoints, and ongoing throughout the workday.
* Coordinates care and services within the case managed population.
* Performs face-to-face assessments of patients/families when appropriate to
identify individualized needs in collaboration with SW.  CM will review
assigned census beginning each day with their SW partner to determine patient
statuses and needs for the day.
* Documentation in the medical record is completed in the appropriate time
frame, accurately reflecting the plan of care and CM interventions. Complies
with CMS regulations related to discharging planning documentation.
* Coordinates referrals of post-acute services such as home health (HH),
hospice, and durable medical equipment (DME). Directs liaison activities to
appropriately integrate with the patient and into the health care continuum.
* Facilitates appropriate referrals surrounding high-cost medications for all
patients, insured or uninsured.  Works with other disciplines along with
support staff to obtain prior authorizations and/or co-pay information to
ensure medication needs are met for discharge and do not create a barrier.
* Ensures coordination of care when patients are transferred: acute hospital to
acute hospital, and jails/prisons. Communicates with outside nursing or case
management staff as appropriate for smooth transition.
* Advocates for the patient and family throughout the entire episode of care.
* Participates in departmental and system performance improvement Initiatives.
* Contributes to Carilion Clinic’s performance improvement activities by
engaging with predictive analytic software.
* Collects and analyzes relevant patient care and fiscal data.
* Analyzes and evaluates the effect of case management on quality outcomes and
fiscal parameters.
* Complies with all departmental policies and practices and fosters teamwork
and professionalism.
* Summary List of Daily Tasks / Expectations of the Nurse Case Manager Role
* Participate in Unit-based IDR morning and afternoon huddles
* Coordinate referrals for DME, HH, Hospice
* Utilize predictive analytic software (example: JVION)
* Complete face-to-face patient assessments
* Communicate with assigned UR nurse and SW partner
* Reassess patients and document status of referrals, movement on barriers
* Aids in the delivery of regulatory letters (IM, HINN)
* Integrates InterQual information during unit huddles and throughout workday
as appropriate
* Provides Medication Assistance to patients identified in need (RX Help, CMAP)
Initiates Medication Investigations (need for authorization, obtain co-pay
information)
* Communicate post-acute care needs of inmates during transitions back to jail
* Assist in acute-acute and transitions of care
* Maintain awareness and anticipate unit-based patient needs
* Provide hand-off communication of unit needs to peers during weekday/weekend
transitions

WHAT WE REQUIRE

Education: Registered Nurse. Bachelor's degree required. 5 years of RN
experience in a hospital setting may be considered in lieu of a bachelor's
degree.

Experience: Three 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. Supervisory
or leadership experience is preferred.

Licensure, certification, and/or registration: Current licensure in Virginia as
a Registered Nurse.

Life Support: AHA BLS- HCP required within 6 months of hire.

Other Minimum Qualifications: Must demonstrate knowledge and competency in the
following areas: satisfactory completion of orientation; positive interpersonal
oral communication skills; effective written communication skills; integrity;
innovation; team player; courteous; ability to resolve complaints/problems;
customer-focused philosophy of service delivery; ability; willingness to work as
an integral member of a multi-skilled team. Also demonstrate knowledge and
competency in; computer literacy; community and system resources; effective
interpersonal relations; assertiveness; flexibility; perseverance; diplomacy and
negotiation.

This job description is only meant to be a representative summary of the major
responsibilities and accountabilities performed by the incumbents of this job.
The incumbents may be requested to perform job-related tasks other than those
stated in this description.

Compensation Range

$76,689.60 - $115,044.80

Employee pay is based on a variety of factors, including qualifications,
credentials, education, and prior work experience. The compensation range does
not include benefits or pension plan.

Recruiter

DANA JOHNSON

Recruiter Email

dejohnson@carilionclinic. org

For more information, contact the HR Service Center at 1-800-599-2537.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment
opportunities to all employees and applicants without regard to race, color,
 religion, sex, national origin, age (40 or older), disability, genetic
information, or veterans status. Carilion is a Drug-Free Workplace. For more
information or for individuals with disabilities needing special assistance with
our online application process contact Carilion HR Service Center at
800-599-2537, 8:00 a. m. to 4:30 p. m., Monday through Friday.

For more information on E-Verify

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BENEFITS, PAY AND WELL-BEING AT CARILION CLINIC

Carilion understands the importance of prioritizing your well-being to help you
develop and thrive.  That’s why we offer a well-rounded benefits package, and
many perks and well-being resources to help you live a happy, healthy life – at
work and when you’re away.

When you make your tomorrow with us, we’ll enhance your potential to realize the
best in yourself. Below are benefits available to you when you join Carilion:

* Comprehensive Medical, Dental, & Vision Benefits
* Employer Funded Pension Plan, vested after five years (Voluntary 403B)
* Paid Time Off (acc