Nurse Case Manager: Transitions & Discharge

PCH Princeton Community Hospital; United States; On-site; USD 70,000 - 95,000; Full time

Job summary

WVU Medicine in Princeton, WV is seeking a dedicated RN to lead transition and discharge planning for a designated patient caseload. You will coordinate with a multidisciplinary team to ensure timely, high-quality care and effective post-acute planning, while educating patients and families about the care pathway.

The role requires an active RN license and 5+ years of clinical nursing experience, with BSN preferred.

Qualifications

• Must hold active RN license in the state where services will be provided, or current multi-state RN license via eNLC.
• Minimum five (5) years of clinical nursing experience.
• BSN degree preferred.

Responsibilities

• Manages transition and discharge planning for assigned patients in a timely manner.
• Collaborates with the multidisciplinary team to facilitate the discharge process for designated caseload.
• Monitors patient progress and ensures the plan of care is patient-centered, high quality, efficient and cost effective.
• Provides education to staff, physicians, patients and families to ensure effective transition planning.
• Develops individualized transition/discharge plans in collaboration with the physician team.
• Communicates plan to the multidisciplinary team and to patient/family; facilitates referrals to post-acute services (homecare, DME, hospice, SNFs, etc.).
• Documents interactions and progress according to departmental policy.

Skills

5+ years clinical experience

Education

BSN

Job description

WVU Medicine in Princeton, WV is seeking a dedicated RN to lead transition and discharge planning for a designated patient caseload. You will coordinate with a multidisciplinary team to ensure timely, high-quality care and effective post-acute planning, while educating patients and families about the care pathway.

The role requires an active RN license and 5+ years of clinical nursing experience, with BSN preferred.