RN Care Navigator: Care Transitions & Coordination

Carilion Clinic; Roanoke, Northern (VA, KY); Hybrid; USD 77,000 - 115,000; Full time

Job summary

Carilion Clinic in Roanoke, VA is seeking an RN Case Manager for a fully in-person role. You will provide case management for designated patient populations, using clinical expertise to optimize outcomes, coordinate care, and promote efficient transitions.

Daily tasks include needs assessments, referrals to post-acute services, and interdisciplinary collaboration to progress the plan of care. You'll also ensure CMS-compliant documentation, participate in team meetings, and use InterQual and

Qualifications

• Registered Nurse with Virginia license and a BSN preferred.
• Bachelor's degree in Nursing required; hospital RN experience considered for degree.
• 3+ years of clinical experience with discharge planning and utilization management.
• AHA BLS-HCP within 6 months of hire; strong communication and teamwork.
• Proficiency with CMS discharge documentation and regulatory requirements.

Responsibilities

• Provide case management for assigned patient populations and coordinate care.
• Perform admissions assessments and facilitate referrals to post-acute services.
• Promote interdisciplinary collaboration and discharge planning to optimize outcomes.
• Ensure CMS regulatory compliance and accurate discharge documentation.
• Collaborate with UR and SW partners; use InterQual and JVION to support status.
• Communicate with patients and families about discharge plans and finances.

Skills

Communication

Team collaboration

Discharge planning

Utilization management

Patient advocacy

Education

Bachelor's degree in Nursing

Virginia RN license

Tools

InterQual

JVION

Job description

Carilion Clinic in Roanoke, VA is seeking an RN Case Manager for a fully in-person role. You will provide case management for designated patient populations, using clinical expertise to optimize outcomes, coordinate care, and promote efficient transitions.

Daily tasks include needs assessments, referrals to post-acute services, and interdisciplinary collaboration to progress the plan of care. You'll also ensure CMS-compliant documentation, participate in team meetings, and use InterQual and