RN, Care Management

Oregon Health & Science University; Portland (OR); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Comprehensive health care plans

Tuition Reimbursement

Vacation 192 to 288 hours per year

Job summary

Oregon Health & Science University in Portland seeks an RN Case Manager to oversee patient assessments, coordinate discharge planning, and collaborate with multidisciplinary teams. This position requires a minimum of three years of clinical nursing experience and a valid Oregon State Registered Nurse License.

The candidate will engage in daily rounds to develop plans ensuring patient safety and effective resource use, contributing to a strategic plan that aims at reducing readmission rates.

Comprehensive health care plans and a supportive work environment with opportunities for professional development are offered.

Qualifications

• Minimum three years of clinical nursing experience in the last 7 years.
• Current, unencumbered Oregon State Registered Nurse License.
• BLS from AHA required.

Responsibilities

• Assess patients on admission for available family support and discharge needs.
• Coordinate post-acute and discharge needs.
• Engage in multidisciplinary rounds to develop patient discharge plans.

Skills

Clinical nursing experience

Care coordination

Communication skills

Discharge planning

Education

Baccalaureate Degree in Nursing

Associate Degree in Nursing

Job description

Department Overview

The Care Management department provides several major services to assure safe and efficient throughput of patients during their acute hospitalization and transition to the next level of care. Our goal is to balance individual clinical and psychosocial patient/family needs with the efficient and cost‑effective utilization of resources while promoting quality outcomes.

Function/Duties of Position

RN case managers assess patients on admission for available family support, insurance resources, and potential discharge planning needs. They engage in daily multidisciplinary rounds Monday through Friday to develop and implement patient discharge plans with input from various other disciplines. The RN case manager is responsible for coordinating post‑acute and discharge needs in a timely and cost‑efficient manner, using established criteria to determine appropriateness of continued hospital stay. RN case managers work with payors on obtaining needed authorizations for ongoing hospitalization and/or identified post‑acute needs.

The RN Case Manager collaborates with the patient and family, members of the multidisciplinary team, community resources and agencies, and payors to ensure the patient’s progress and level of care is appropriately determined. Intensity of service is dependent on individual patient needs as assessed by the case manager. RN case managers practice robust utilization and resource management. RN case managers also frequently lead multidisciplinary and family care conferences involving complex care situations and contribute to meeting OHSU’s strategic plan of safe length of stay reduction and reduction in readmission rates. Case Management is represented in every adult and pediatric unit and in the Emergency department. Each Case Manager has an office with a workstation near the unit they are assigned to. Communication factors: Case Managers are available by pagers, telephone/voicemail, Microsoft Teams, Epic Secure Chat, and e‑mail.

Specialty Case Management Roles

ED RN Case Manager

• Using approved criteria, conducts a comprehensive patient/family assessment and admission clinical review upon admission to the emergency department to ensure appropriateness of the care setting.
• Provide early identification of high‑risk patients and their needs.
• Perform care coordination and discharge planning for patients in the Emergency department and Observation units.
• Assess patients’ potential to discharge from the emergency department with community care coordination.
• Round with Advance Practice Providers at designated times BID.
• Assist the transfer center with coordinating appropriate patient transfers out of the emergency department.
• Educate providers regarding documentation requirements that support medical necessity determinations.
• Deliver Medicare notifications including but limited to: Condition Code 44 notices, Observation notices, and Medicare Important Messages.
• Document according to departmental policy.
• Leads the effort to ensure compliance with CMS and other insurance regulations related to Care Management.
• Other functions as assigned.

Evening Shift RN Case Manager

• Provide nurse case management support to patients, families, and staff in both the inpatient and emergency department settings for the evening shift 7 days per week.
• Receives referrals and hand offs from day shift case managers.
• Complete hand off of information to day shift case managers.
• Troubleshoot and resolve any discharge delays or barriers carrying over into evening shift.
• Other functions as assigned.

RN Case Managers are responsible for being aware of and complying with regulatory requirements of DNV, Medicaid, Medicare, and Oregon Nurse Practice Act.

Required Qualifications

• Minimum three (3) years of clinical nursing experience in the last 7 years.
• Minimum one (1) year of Care coordination/transitions of care, charge nurse, home health, and/or hospital at home RN experience.
• BSN Graduates: Baccalaureate Degree in Nursing from a program accredited by Commission of Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN) or Commission for Nursing Education Accreditation (CNEA) 30 days before start date.
• ADN Graduates: Associate Degree in Nursing from an accredited program 30 days before the start date.
• Associate degree Nurses required to enroll in BSN program within 3 years of hire and complete within 5 years of hire.
• Current, unencumbered Oregon State Registered Nurse License.
• BLS from AHA required. New hires will be enrolled and required to complete during orientation.
• Must be able to perform the essential functions of the position with or without accommodation.

Preferred Qualifications

Case Management Certification (ACMA, RN‑BC, CMSA); Hospital‑based case management experience.

Proficiency in managing difficult and sensitive family and provider care conferences including adjustment to new levels of function, end‑of‑life discussions, imbalance of available resources (social, spiritual, medical, financial).

Progressive leadership positions within a nursing unit, examples include Charge nurse, UBNPC Chair/Member, Shared Governance councils.

Minimum two (2) years of Inpatient Case/Care Management experience in the last 5 years.

Additional Details

Length of Orientation – Experienced Nurse

• External candidates: OHSU & Nursing New Employee Orientation (NEO) for about a week.
• Either Transition to Practice (TTP) Program Specialty Fellowship/Fellowship Learning Pathway or Orientation experience for 3 days-26 weeks depending on the care area. An employment service agreement may apply.

Benefits

• Comprehensive health care plans. Covered at 100% of the cost for full‑time employees and 88% for dependents.
• $50K of term life insurance provided at no cost to the employee.
• Two separate above market pension plans to choose from.
• Vacation – 192 to 288 hours per year depending on length of service, prorated for part‑time.
• Holidays – up to 64 holiday hours per calendar year (employees accrue .0308 holiday hours for each hour paid – included in vacation accruals).
• Sick Leave – 96 hours per year, prorated for part‑time.
• Substantial public transportation discounts (Tri‑met and C‑Tran).
• Tuition Reimbursement.
• Innovative Employee Assistance Program (EAP) including extensive wellness resources.

All are welcome. OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti‑racist, multicultural institution and encourage people with diverse backgrounds to apply.

To request reasonable accommodation, contact [e-mail]