RN, Care Manager

At Whidbey Health, we believe exceptional patient care starts with a great team. We're looking for more than an experienced RN Care Manager—we're looking for someone who values collaboration, brings a positive attitude, and takes pride in delivering exceptional care. The ideal candidate is detail-oriented, adaptable, and thrives in a fast-paced environment where priorities can change quickly. If you communicate effectively, enjoy solving complex problems, and are passionate about making a meaningful difference for our patients and community, we'd love to have you join our Transitions of Care team.

The RN - Care Manager is a health care professional with experience and background to assure compliance with CMS Conditions of Participation regarding Utilization Review and Discharge Planning. The RN – Care Manager will lead an assessment to identify the patient's clinical needs to be accommodated and constructs a care plan to include DME, home health, Hospice, skilled nursing, anti‑biotic regime, etc.

The RN – Care Manager follows the hospital's Case Management/Utilization Plan that integrates the functions of utilization review, discharge planning, and resource management into a singular effort to ensure, based on patient assessment, care is provided in the most appropriate setting utilizing medically indicated resources to improve quality through coordination of care impacting length of stay, minimizing cost, and ensuring optimum outcomes.
The RN – Care Manager evaluates patient's care delivery process while in the hospital, as well as performs denial management either during admission or post discharge. The RN – Care Manager acts as a resource to the interdisciplinary team providing clinical expertise in the areas of utilization review, status determination, clinical resource utilization, the discharge planning and appeal/denial management. The RN – Care Manager serves as the organizational consultant to providers and staff to optimize patient throughput and assure that the organization and the patient's care are managed in the most efficient manner possible and a collaborative practice to improve quality through coordination of care impacting length of stay, minimizing cost, and ensuring optimum outcomes.

The RN – Care Manager communicates with the patient, family and the interdisciplinary health care team using the nursing process to assess, plan, implement, monitor, and evaluate options and services required to meet a patient’s physical, emotional, and social health needs in preparation for post hospital discharge.

* Much of the care coordination process is done via electronic communication. The RN – Care Manager is expected to check their Whidbey Health email at minimum 3 times a day and utilize TEAMS messaging.

PRINCIPLE FUNCTIONS includes the following, other duties may be assigned:

• Acts as an interdisciplinary team member within the Transitions Department.
• Performs pre-admission status recommendation review for multiple care settings as assigned (i.e., Emergency Department, Direct Admission/Transfer, and/or elective procedure), to communicate with providers status guidance based on available information.
• Completes an initial needs assessment when a patient is admitted, in observation status or any other time deemed necessary by the interdisciplinary team.
• Completes rehospitalization assessment for readmissions.
• Works closely with the care team to navigate the individualized care plan through in-hospital stay to discharge:
  When the patient and or family has specific adjustment or psych/social needs, the social worker is integrated into the care plan to a large degree. Social Work will also assist CMRN with placement of patients into prescribed facility care.
• May contact providers,…