Registered Nurse; RN Case Manager

Job Summary

Inova Fair Oaks Hospital is looking for a dedicated Registered Nurse Case Manager to join the Case Management Team. This role will be Part‑Time Day shift, 20 hours per week, 8 AM – 4:30 PM; rotating weekends, one major and one minor holiday. The RN Case Manager provides discharge planning and continuity of care for assigned patients in acute and post‑acute settings, coordinates services, and acts as key liaison between patients, families and interdisciplinary healthcare members.

Uses utilization management techniques to determine medical necessity, appropriateness and efficiency of healthcare services, and participates in clinical performance improvement activities.

Inova Fair Oaks is a top‑ranked 174‑bed acute care community hospital serving the rapidly growing suburbs of Northern Virginia. Inova Fair Oaks Hospital is committed to safe care, excellent service and continuous improvement of each patient’s unique experience.

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
• Retirement:
  Inova matches the first 5 % of eligible contributions – starting on your first day.
• Tuition and Student Loan Assistance: up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental‑health coaching or therapy sessions, per person, per year, at no cost.
• Work/Life Balance: offering paid time off and paid parental leave.

• Collect delay and other data for specific performance and/or outcome indicators; assist in the collection and reporting of resource and financial indicators, including acute and post‑acute case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals.
• Analyze variances from plans of care and care paths with physicians and other healthcare team members; use concurrent variance data to drive practice changes and positively impact outcomes.
• Ensure safe care to patients by adhering to policies, procedures and standards within budgetary specifications, including time management, supply management, productivity and accuracy of practice.
• Promote individual professional growth and development by meeting requirements for mandatory/continuing education and skill competency; support department‑based goals that contribute to the success of the organization.
• Provide discharge planning and continuity of care for assigned patients in the acute and post‑acute setting; initiate and facilitate referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated.
• Collaborate with the interdisciplinary healthcare team, patients and families in assessment and coordination of discharge planning needs, post‑discharge services, and transition of patients from hospitals to discharge settings.
• Document relevant discharge planning information in medical records according to department standards and care‑management plans.
• Collaborate/communicate with internal and external case managers; understand pre‑acute and post‑acute resources; coordinate services; act as liaison between patients, families and interdisciplinary team.
• Provide educational resources and referrals to patients and families to address identified needs such as social or financial; advocate for patients to resolve barriers to care.
• Use utilization management techniques to determine medical necessity, appropriateness and efficiency of healthcare services, procedures and facilities.
• Discuss payer criteria and issues on a case‑by‑case basis with clinical staff; follow‑up to resolve problems with payers as needed; apply approved clinical criteria to monitor appropriateness of admissions and continued stays.
• Identify at‑risk populations using approved screening tools; monitor LOS and ancillary resource use; take actions to achieve continuous improvement efficiencies; refer cases appropriately.
• Participate in assessment of patients’ clinical and psychosocial needs through review of patient information, personal contact with patients/families…