RN Registered Nurse Care Manager

AdventHealth

Killeen (TX)

On-site

USD 47,000 - 87,000

Full time

8 hours ago

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Benefits offered by this job

Benefits from Day One

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources

Pet Benefits

Job summary

AdventHealth in Killeen, TX is seeking an experienced Registered Nurse - Case Manager to lead discharge planning and care coordination across inpatient, observation, and emergency settings.

You will assess patient needs, educate families, collaborate with multidisciplinary teams, and ensure timely transitions while navigating post-acute care resources.

A RN with CCM preferred, strong communication, and CMS discharge planning knowledge is desired.

Qualifications

RN licensed in Texas or eligible for licensure.
Strong discharge planning and care coordination experience.
Knowledge of CMS Conditions of Participation for Discharge Planning.

Responsibilities

Participates in rounds to review patient status and discharge plans.
Educates patients and families on illness impacts and resources.
Documents discharge plans, barriers, and progress in medical records.
Coordinates post-acute care and authorization with payors as needed.
Leverages community resources to ensure timely transitions.

Skills

Leadership

Process analysis

Critical thinking

Multitasking

Customer service

Diversity & inclusion

Organization

Outlook & EMR

Adaptability

Community resources

CMS discharge planning knowledge

Teamwork

Education

Associate's in Nursing

Bachelor's in Nursing

Tools

Outlook

EMR systems

Job description

Our Promise To You

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that

Our Promise To You

All the benefits and perks you need for you and your family:

Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
Paid Time Off from Day One
403-B Retirement Plan
4 Weeks 100% Paid Parental Leave
Career Development
Whole Person Well-being Resources
Mental Health Resources and Support
Pet Benefits

Schedule

Full time

Shift

Day (United States of America)

Address

2201 S CLEAR CREEK RD

City

KILLEEN

State

Texas

Postal Code

76549

Job Description

Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate. Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services. Assesses readmitted patients for the patient’s and family’s perceived reasons for the readmission. Organizes and facilitates patient and family care conferences with the multidisciplinary team. Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work. Communicates with Payors patient’s needs for authorization for post-acute care as needed. Assesses patients’ and families’ wholistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning. Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan. Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs. Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate. Other duties as assigned.

Knowledge, Skills, and Abilities

Leadership skills [Required]
Process and Outcome data analysis skills [Required]
Critical thinking and problem-solving skills [Required]
Ability to manage multiple tasks and prioritize levels of importance [Required]
Customer service skills [Required]
Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change [Required]
Effective organizational skills [Required]
Computer proficiency with Outlook e-mail and electronic medical records [Required]
Flexible in a complex and changing healthcare environment [Required]
Knowledge of community resources and post-acute care programs across the continuum [Required]
Knowledge of clinical and social factors that affect the patient's functional status at discharge [Required]
Knowledge of CMS Conditions of Participation for Discharge Planning [Required]
Conflict management and resolution skills [Required]
Teamwork principles [Required]