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.
Education: Associate Degree in Nursing or diploma from an accredited nursing program required.
Experience: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.
Licensure, Certification, and/or Registration:Current Registered Nurse licensure in Virginia required. AHA BLS- HCP required within 6 months of hire.
Other Minimum Qualifications: Effective interpersonal, oral, and written communication skills required. Demonstrated integrity, innovation, diplomacy, assertiveness, flexibility, and perseverance required. Ability to work collaboratively as an integral member of a multidisciplinary team required. Strong customer service orientation and the ability to resolve complaints and problems effectively required. Effective negotiation and relationship-building skills required. Computer literacy required.
This job description is intended to be a representative summary of the major responsibilities and accountabilities performed by incumbents in this role. Incumbents may be required to perform job-related tasks other than those specifically presented in this description.
Compensation Range:
$76,689.60 - $115,044.80Employee 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 JOHNSONRecruiter Email:
dejohnson@carilionclinic.orgFor 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: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies
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:
| Location | Roanoke, Virginia |
| Website | carilionclinic.org/eoe-e-verify-and-right-work-policies |
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