RN Case Manager - ED Observation Unit Weekends

RN Case Manager – ED Observation Unit (Full Time, Weekends)

Provide case management for assigned patient populations within the Emergency Department Observation Unit. Utilize clinical expertise, communication, and problem‑solving skills to achieve optimal clinical and resource outcomes, promote cost‑effective care, and facilitate patient/family movement through the health care organization.

• Perform patient needs assessments upon admission and at regular intervals; facilitate referrals and link patients/families to health, wellness, and post‑acute care resources.
• Collaborate with Utilization Review Nurse and maintain regular contact throughout the day; use Inter Qual software to support accurate patient status determination.
• Aid in the delivery of regulatory letters and patient notices related to insurance coverage/non‑coverage; ensure documentation reflects patient’s condition and treatment for appropriate admission status/DRG assignment.
• Communicate with patients/families to ensure understanding of financial implications of discharge plans.
• Participate actively in Interdisciplinary Team Meetings; provide feedback and manage changes to the plan of care as necessary.
• Maintain effective communication with all disciplines to promote timely and appropriate discharges; coordinate care and services within the case‑managed population.
• Perform face‑to‑face assessments of patients/families as needed; document interventions within the medical record in a timely manner.
• Coordinate referrals to post‑acute services (home health, hospice, durable medical equipment) and obtain prior authorizations/co‑pay information to avoid barriers to medication and discharge.
• Facilitate appropriate referrals for high‑cost medications; work with disciplines and support staff to secure coverage.
• Coordinate transitions of care, including transfer to other hospitals and correctional facilities; communicate with external nursing or case‑management staff.
• Advocate for the patient and family throughout the entire episode of care; participate in departmental and system performance‑improvement initiatives; analyze and evaluate case‑management impact on quality outcomes and fiscal parameters.

• Registered Nurse with current Virginia licensure.
• Bachelor’s degree in nursing (or five years of RN experience in a hospital setting may be considered in lieu of a bachelor’s degree).
• Minimum three years of recent clinical experience with direct patient care management, including planning, coordination, and delivery of education, psychosocial support, discharge planning, and utilization management.
• Supervisory or leadership experience is preferred.
• Current AHA BLS‑HCP certification within six months of hire.
• Demonstrated knowledge and competency in orientation, oral and written communication, integrity, innovation, teamwork, courtesy, problem resolution, customer‑focused service delivery, computer literacy, community and system resources, interpersonal relations, assertiveness, flexibility, perseverance, diplomacy, and negotiation.

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.

• Comprehensive Medical, Dental, and Vision benefits
• Employer‑funded pension plan (vested after five years) and voluntary 403B
• Paid time off accrued from day one
• On‑site fitness studios and discounts to Carilion Wellness centers
• Access to health and wellness app, Virgin Pulse
• Discounts on childcare
• Continued education and training