Registered Nurse (RN) - Case Manager - Southside Regional

Registered Nurse (RN) - Case Manager
Location: Southside Regional

Salary: $1,820.27 per week (approx.)

What We Offer

Competitive pay, incentives, referral bonuses, and a 403(b) plan with employer contributions (when eligible)

Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources, and discounts

Paid time off, parental and FMLA leave, short- and long-term disability, backup care for children and elders

Tuition assistance, professional development, and continuing education support

Benefits may vary based on the market and employment status.

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. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact recruitment@mercy.com.

Primary Function
The RN Care Manager is responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. The role utilizes a collaborative process; the RN Care Manager identifies, assesses, plans, implements, and evaluates the options and services required to meet an individual’s health and health-related needs, including social determinants that affect overall 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

Identifies and prioritizes patients in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors.

Plans with the patient, caregivers, and members of the healthcare team to maximize health care responses, quality, and cost-effective outcomes; monitors and revises the plan as indicated when patient condition changes.

Completes all necessary documentation, maintaining clear, concise, and timely records that reflect patient needs, and utilizes handovers at points of care or staff changes.

Documents the plan of care to address post-hospital care needs and resources, ensuring patient and caregiver involvement and preferences are incorporated into the transition 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 and removing barriers to progression of care and participating in Interdisciplinary Discharge Rounds.

Promotes proactive care by removing barriers related to timely testing and treatment, and ensures resources are utilized appropriately, offering alternatives to acute care.

Collaborates with revenue cycle partners to ensure appropriate patient classification and with patient access to deliver regulatory letters in a timely manner.

Participates in departmental clinical outcome projects and process improvement initiatives within the care management department.

Communicates respectfully and clearly to achieve facility and departmental goals and daily work.

Promotes a team-based approach to accomplish work and supports compliance with CMS and Conditions of Participation for discharge planning and utilization management.

Licensing & Certification

BLS Basic Life Support – American Heart Association (required)

RN License in the state of employment or covered by a compact (required)

Accredited Case Manager Certification (ACM), Certified Case Manager (CCM), or ANCC Nursing Case Management board certification (preferred)

Education

Bachelor of Science in Nursing (preferred for BSMH, required for RSFH)

Experience

1 year of experience in a clinical setting (required)

3 years of experience in an acute care clinical setting (preferred)

Ambulatory or post-acute care coordination experience (preferred)

Patient Population

Neonates (0-4 weeks)

Infant (1-12 months)

Pediatrics (1-12 years)

Adolescents (13-17 years)

Adults (18-64 years)

Geriatrics (65 years and older)

Working Conditions

Periods of high stress and fluctuating workloads may occur.

General office environment.

May be exposed to high noise levels, bright lights, physical altercations, verbal abuse, and hazardous substances.

May require use of physical restraints and handling of human blood or other potentially infectious materials.

May be exposed to adverse weather conditions and required car travel to off-site locations.

May involve prolonged periods working alone and constant interruptions.

Universal precautions, personal protective equipment, and infection control policies are mandatory.

Physical Demands

Lifting/Carrying up to 50 lbs.; pushing/pulling up to 50 lbs.; stooping, kneeling, crawling, climbing, balancing, bending.

Physical Requirements & Hazards

Manual dexterity, maneuver weight of patients, shift work, hearing alarms, finger dexterity, acuity near.

Use of latex products.

Key Skills

Care management, discharge planning, patient advocacy, flexibility, care planning, care coordination, analyzing data, reimbursement methodologies, staffing workflow and bed allocation, clinical knowledge, tracking, local and state resource knowledge, payor regulation knowledge, knowledge sharing, attention to detail, critical thinking, communication with families, conflict resolution, proactivity, problem solving, active listening, relationship building, teamwork, facilitation.

Note: This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as directed by their supervisor, subject to reasonable accommodation.

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