RN Case Manager - Inpatient

CP01 Carilion Medical Center; Roanoke (VA); On-site; USD 77,000 - 115,000; Full time

Benefits offered by this job

Medical, Dental, Vision benefits

Pension plan

Paid time off

Onsite fitness facilities

Educ. opportunities

Job summary

Carilion Clinic in Roanoke, VA is seeking an RN Case Manager for inpatient care. You will lead case management activities, assess patient needs, coordinate referrals, and ensure coordinated, cost-effective transitions across the care continuum.

Requires RN license in Virginia, BSN, and 3+ years of clinical case management experience. Strong communication and teamwork skills are essential for success in this role.

Qualifications

• RN Case Manager provides case management for assigned patient populations.
• Performs patient needs assessments upon admission and at regular intervals.
• Promotes cost-effective care by coordinating care and avoiding fragmentation.
• Collaborates with Utilization Review Nurse and uses InterQual software.

Responsibilities

• Manage case load for inpatient units and coordinate referrals.
• Promote discharge planning and transitions to next level of care.
• Communicate with patients/families about plan of care and financial implications.
• Participate in interdisciplinary team meetings and performance initiatives.

Skills

Case management

Discharge planning

Patient needs assessments

Interdisciplinary collaboration

Communication skills

Utilization management

InterQual software

Education

Bachelor's degree in nursing

RN licensure in Virginia

BLS-Healthcare Provider

Tools

InterQual

Job description

Employment Status: Full time Shift: Day/Evening (United States of America) Facility: 1906 Belleview Ave SE - Roanoke Requisition Number: R162823 RN Case Manager - Inpatient (Open)

How You’ll Help Transform Healthcare:

Monday - Friday, 8am-4:30pm The RN Case Manager provides case management for assigned patient populations. Utilizes clinical expertise, communication and problem-solving skills to achieve optimal clinical and resource outcomes. Promotes cost-effective care by minimizing fragmentation, maximizing coordination, and facilitating patient/family movement through the health care organization. Performs patient needs assessments upon admission and at regular intervals, facilitating referrals and providing linkages to health, wellness, and post-acute care resources across the health care continuum. Promotes interdisciplinary collaboration and teamwork to progress the plan of care and discharge plan. Promotes appropriate length of stay, resource management, and care transitions to the next level of care. Must comply with all federal and state regulations surrounding the discharge process. Must possess knowledge of growth and development appropriate to age group served and incorporate plan to meet needs into plan of care. The RN Case Manager provides case management for assigned patient populations. Utilizes clinical expertise, communication and problem-solving skills to achieve optimal clinical and resource outcomes. Promotes cost-effective care by minimizing fragmentation, maximizing coordination, and facilitating patient/family movement through the health care organization. Performs patient needs assessments upon admission and at regular intervals, facilitating referrals and providing linkages to health, wellness, and post-acute care resources across the health care continuum. Promotes interdisciplinary collaboration and teamwork to progress the plan of care and discharge plan. Promotes appropriate length of stay, resource management, and care transitions to the next level of care. Must comply with all federal and state regulations surrounding the discharge process. Must possess knowledge of growth and development appropriate to age group served and incorporate plan to meet needs into plan of care. Collaborates with Utilization Review Nurse. Maintains regular contact with assigned Utilization Review Nurse throughout the day. Uses InterQual software to support accurate patient statuses according to ongoing medical necessity. Aids in the delivery of regulatory letters and patient notices related to insurance coverage/non-coverage, using support staff as appropriate. Ensures documentation accurately reflects the patient’s condition, co-mordities, treatment and procedures that support the most appropriate admission status and DRG assignment. Communicates with patients/families to ensure understanding financial implications of discharge plans Facilitates an interdisciplinary approach to patient care. Actively participates in Interdisciplinary Team Meetings on assigned units, sharing meaningful and professional knowledge to the team discussion regarding progression of care. Provides feedback to the health care team verbally and via chart entries regarding the patient's progress toward reaching expected outcomes or about barriers to the plan. Manages changes to the plan as necessary. Maintains effective communications with all disciplines to promote timely and appropriate discharges. Daily communication with Social Work and Utilization Review: includes case reviews, morning touchpoints, and ongoing throughout the workday. Coordinates care and services within the case managed population. Performs face-to-face assessments of patients/families when appropriate to identify individualized needs in collaboration with SW. CM will review assigned census beginning each day with their SW partner to determine patient statuses and needs for the day. Documentation in the medical record is completed in the appropriate time frame, accurately reflecting the plan of care and CM interventions. Complies with CMS regulations related to discharging planning documentation. Participates in departmental and system performance improvement Initiatives. Contributes to Carilion Clinic’s performance improvement activities by engaging with predictive analytic software. Collects and analyzes relevant patient care and fiscal data. Analyzes and evaluates the effect of case management on quality outcomes and fiscal parameters. Complies with all departmental policies and fosters teamwork and professionalism.

Summary List of Daily Tasks / Expectations of the Nurse Case Manager Role

• Participate in Unit-based IDR morning and afternoon huddles
• Coordinate referrals for DME, HH, Hospice
• Utilize predictive analytic software (example: JVION)
• Complete face-to-face patient assessments
• Communicate with assigned UR nurse and SW partner
• Reassess patients and document status of referrals, movement on barriers
• Aids in the delivery of regulatory letters (IM, HINN)
• Integrates InterQual information during unit huddles and throughout workday as appropriate
• Provides Medication Assistance to patients identified in need (RX Help, CMAP)
• Initiates Medication Investigations (need for authorization, obtain co-pay information)
• Communicate post-acute care needs of inmates during transitions back to jail
• Assist in acute-acute and transitions of care
• Maintain awareness and anticipate unit-based patient needs
• Provide hand-off communication of unit needs to peers during weekday/weekend transitions

What We Require:

Education: Registered Nurse. Bachelor's degree required.

Bachelor's degree required.

5 years of RN experience in a hospital setting may be considered in lieu of a bachelor's degree.

Experience: Three 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. Supervisory or leadership experience is preferred.

Licensure, certification, and/or registration: Current licensure in Virginia as a Registered Nurse. Life Support: AHA BLS- HCP required within 6 months of hire.

Other Minimum Qualifications: Must demonstrate knowledge and competency in the following areas: satisfactory completion of orientation; positive interpersonal oral communication skills; effective written communication skills; integrity; innovation; team player; courteous; ability to resolve complaints/problems; customer-focused philosophy of service delivery; ability; willingness to work as an integral member of a multi-skilled team. Also demonstrate knowledge and competency in; computer literacy; community and system resources; effective interpersonal relations; assertiveness; flexibility; perseverance; diplomacy and negotiation.

Compensation Range: $76,689.60 - $115,044.80 Employee 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.

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 on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies

Benefits, Pay and Well-being at Carilion Clinic

• Comprehensive Medical, Dental, & Vision Benefits
• Employer Funded Pension Plan, vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• Onsite fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app, Personify Health
• Discounts on childcare
• Continued education and training

In our workplace, we're devoted to the success of our employees. No matter where you are in your career, we will help you continue to learn, grow, and share your knowledge with others.

Join an organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, fully dedicated, and forever curious.

Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, and multi‑specialty physician practices spanning southwestern Virginia.

Join us and begin your career in a place where every day is a new adventure of creating the future of health care.