RN Case Manager

Job Overview

Employment Status:
Full Time. Shift: Day/Evening (United States of America). Facility: 1906 Belleview Ave SE – Roanoke. Requisition Number: R151592. RN Case Manager (Open). How You’ll Help Transform Healthcare:
Full time – Monday to Friday, 8:00 a.m. to 4:30 p.m. Sign‑on bonus and relocation assistance available.

• Provide case management for assigned patient populations, utilizing clinical expertise, communication, and problem‑solving skills to achieve optimal clinical and resource outcomes.
• Promote cost‑effective care by minimizing fragmentation, maximizing coordination, and facilitating patient/family movement through the health care organization.
• Conduct patient needs assessments upon admission and at regular intervals; facilitate referrals and linkages to health, wellness, and post‑acute care resources.
• Collaborate with interdisciplinary teams to progress the plan of care and discharge plan; promote appropriate length of stay and resource management.
• Comply with all federal and state regulations surrounding the discharge process; maintain documentation that reflects patient condition, co‑morbidities, treatment, and procedures for admission status and DRG assignment.
• Maintain regular contact with assigned Utilization Review Nurse throughout the day; use Inter Qual software to support accurate patient status and medical necessity.
• Coordinate care and services within the case‑managed population; liaise with social work, utilization review, and other disciplines.
• Facilitate timely and appropriate discharges; communicate with patients/families regarding financial implications and discharge plans.
• Participate in interdisciplinary team meetings, unit‑based IDR huddles, and daily case reviews; provide verbal and chart feedback on patient progress.
• Coordinate referrals for post‑acute services (home health, hospice, durable medical equipment) and high‑cost medication assistance.
• Assist in transitions of care, including acute‑to‑acute transfers and inmate transitions; advocate for patients and families throughout the episode of care.
• Participate in departmental and system performance‑improvement initiatives; analyze data and evaluate case‑management impact.

• Participate in unit‑based IDR morning and afternoon huddles.
• Coordinate referrals for DME, HH, and Hospice.
• Use predictive analytic software (e.g., JVION) to assess patient data.
• Complete face‑to‑face patient assessments.
• Communicate with assigned UR nurse and SW partner.
• Reassess patients and document status of referrals and barriers.
• Aid in delivery of regulatory letters (IM, HINN).
• Integrate Inter Qual information during unit huddles.
• Provide medication assistance and investigate authorization needs.
• Communicate post‑acute care needs of inmates during transitions back to jail.
• Assist in acute‑to‑acute and transitions of care.
• Maintain awareness of unit‑based patient needs.
• Provide hand‑off communication of unit needs to peers during weekday/weekend transitions.

• Registered Nurse with current licensure in Virginia.
• Bachelor’s degree required; five years of RN experience may be considered in lieu of a bachelor’s.
• Three years of recent clinical experience with direct patient‑care management, discharge planning, and utilization management.
• Slight supervisory or leadership experience preferred.
• AHA BLS‑HCP certification required within six months of hire.
• Demonstrated knowledge of regulatory requirements, systems, and community resources.
• Computer literacy and proficiency with Inter Qual, predictive analytics, and electronic medical records.
• Strong interpersonal, written, and verbal communication skills.
• Team player, customer‑focused, innovative, flexible, and able to resolve complaints.

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