Overview Registered Nurse (RN) Care Manager - Memorial Regional Medical Center at Bon Secours. The RN Care Manager is responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. This role uses a collaborative process to identify, assess, plan, implement and evaluate options and services to meet health and health-related needs, including social determinants that affect wellbeing. The RN Care Manager screens, identifies, and assesses individuals in need of active Case Management services and promotes the right resources at the right time and place.
Essential Job Functions / Responsibilities Identifies and prioritizes patients in need of care management services using a holistic approach (biopsychosocial, functional, cultural, spiritual, financial factors). Plans with the patient, caregivers and healthcare team to maximize health care responses, quality and cost-effective outcomes. Monitors and revises the plan as indicated when patient condition changes.
Completes documentation; maintains clear, concise, and timely documentation in the patient record to reflect patient needs. Utilizes handovers at points of level of care change, staff change, and during care transitions.
Documents the plan of care to address post-hospital care needs and resources, with evidence of patient, family or caregiver involvement in planning. Ensures treatment goals and preferences are incorporated into transition of care planning and communicated to the multidisciplinary team.
Follows standardized practices related to Advance Care Planning, length of stay management and readmission prevention.
Supports denial prevention related to medical necessity by addressing/removing barriers to progression of care and participating in Interdisciplinary Discharge Rounds.
Promotes proactive care, assists in removing barriers to timely testing and treatment, ensures resources are utilized appropriately, and offers alternatives to acute care to the care team.
Collaborates with revenue cycle partners to remove barriers and ensure patients are classified appropriately as guided by the physician.
Works with patient access to ensure regulatory letters are delivered to the patient in a timely manner.
Participates in department clinical outcome projects and process improvement initiatives within the care management department.
Works collaboratively with peers to achieve facility and department goals, maintaining respectful and clear communication.
Shares responsibilities and promotes a team-based approach to tasks; develops strong partnerships with other care team members.
Supports compliance with CMS and Conditions of Participation for discharge planning and utilization management; addresses opportunities or concerns with leadership.
Stays updated on community resources to facilitate safe patient transitions of care and remains current on clinical advancements related to primary patient population. Employees may be required to perform other duties as assigned by their supervisor.
Licensing / Certification BLS Basic Life Support – American Heart Association (required)
RN License in the state of practice or listed as compact state (required)
Accredited Case Manager Certification (ACM) from American Case Management Association or Certified Case Manager (CCM) from CCMC, or ANCC Nursing Case Management board certification (preferred)
Education Bachelor of Science in Nursing (BSN) (preferred for some sites; required where specified)
Work Experience 1 year of experience in a clinical setting (required)
3 years of experience in an acute care clinical setting (preferred)
About Us Bon Secours is a faith-based, patient-focused organization dedicated to enhancing the health and well-being of people in mind, body and spirit through exceptional patient care. We value compassion, collaboration, excellence and respect and seek people committed to these values to create an environment where associates thrive.
Benefits offerings vary by employment status and may include medical, dental and vision plans, prescription drug coverage, flexible spending accounts, life insurance with AD&D, retirement plan contributions, paid time off, educational assistance, and more.
Equal Opportunity All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. For more information, request accommodations or access our affirmative action policy, contact recruitment@mercy.com.
Note: This description reflects the current job and is not an exhaustive list of duties, responsibilities, or qualifications. The organization may require additional duties as needed.