RN Care Transitions & Case Management Specialist

Cape Fear Valley Health System; United States; On-site; USD 68,000 - 95,000; Full time

Job summary

Cape Fear Valley Health System in Fayetteville, NC seeks a Registered Nurse to support Community Alternatives Program Services. You will perform nursing assessments, provide education, and coordinate care in collaboration with an interdisciplinary team.

Responsibilities include case management, transitioning beneficiaries between care settings, and ensuring timely documentation in e-CAP and EPIC. NC RN licensure and CCM certification preferred; 2+ years in acute care or care coordination are

Qualifications

• Associate degree in nursing required; bachelor's preferred.
• NC or compact state RN licensure required.
• CCM certification preferred.
• 2 years acute care or healthcare setting experience required; 1 year in case management/care coordination.

Responsibilities

• Perform nursing assessments for CAP beneficiaries at intake and during status changes.
• Provide case management and care coordination to assigned caseload.
• Coordinate Money Follows the Person and Community Transitions to reduce LOS and readmissions.
• Develop care plans with beneficiaries and support persons with person-centered goals.
• Monitor services monthly to quarterly and ensure timely documentation.
• Conduct follow-up visits to reduce readmissions after discharge.
• Document in e-CAP and EPIC; support performance improvement.
• Develop resources for the population via grants and interdepartmental collaboration.
• Perform other duties as assigned.

Skills

Care coordination

Communication

Critical thinking

Organizational skills

Problem solving

Education

Associate’s degree in nursing

Bachelor’s degree in nursing

Tools

EPIC

e-CAP

Job description

Cape Fear Valley Health System in Fayetteville, NC seeks a Registered Nurse to support Community Alternatives Program Services. You will perform nursing assessments, provide education, and coordinate care in collaboration with an interdisciplinary team.

Responsibilities include case management, transitioning beneficiaries between care settings, and ensuring timely documentation in e-CAP and EPIC. NC RN licensure and CCM certification preferred; 2+ years in acute care or care coordination are