Position
RN Registered Nurse Case Manager at AdventHealth
Benefits
Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
Paid Time Off from Day One
403-B Retirement Plan
4 Weeks 100% Paid Parental Leave
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
Schedule
Full Time 40 hours/week, Monday-Friday 9a-5p, Occasional weekend coverage as needed
Location
701 WINTHROP AVE, Glendale Heights, 60139
Role Overview
The RN Care Manager collaborates with the patient/family, social workers, nurses, physicians and the interdisciplinary team to ensure patient-centered care coordination and progression through the continuum of care. The RN Care Manager ensures efficient and cost‑effective care through appropriate resource monitoring and clinical care escalations. Under the supervision of the Care Management Supervisor, Manager or Director of Nursing, the RN Care Manager evaluates post‑hospital needs, develops transition of care plans, and initiates implementation prior to discharge. The RN Care Manager optimizes patient flow and throughput, enhances continuity of care, smooth and safe transitions, patient satisfaction, patient safety, readmission prevention, and length‑of‑stay management. The RN Care Manager communicates daily during multidisciplinary rounds, coordinates discharge planning, and ensures regulatory compliance. The RN Care Manager facilitates collaboration across the continuum, removes barriers to timely care delivery, and provides education on utilization, medical necessity, CMS Conditions of Participation, and discharge planning. The RN Care Manager is knowledgeable of post‑hospital care services such as Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, Transitional Care Clinics, supportive programs, follow‑up appointments, Skilled Nursing Facilities, Rehabilitation Services, and community organizations.
Key Responsibilities
Actively participate in multidisciplinary rounds to review patient status changes, progression, discharge plans, and resource needs; educate patients and families; manage readmission assessments; facilitate care conferences; document discharge planning evaluations, MDRs, barriers, avoidable days, and needs; communicate with payors for post‑acute authorization; assess families holistically; review medical records; develop discharge plans with contingency; leverage technology for coordination; demonstrate other duties as assigned.
Value You Bring To The Team
Actively participates in multi-disciplinary rounds to review changes in patient status, progression and level of care, and discharge plans for all assigned patients to identify resources necessary at discharge and ensure a timely transition, escalating care delays to leadership as appropriate.
Communicates with and educates patients and families regarding emotional, social, and financial impacts of illness and mobilizes family/community resources to meet identified needs while advocating for patient and family empowerment in making health care decisions and accessing needed services.
Assesses readmitted patients for the patients and family's perceived reasons for the readmission.
Organizes and facilitates patient and family care conferences with the multidisciplinary team.
Documents discharge planning evaluation, ongoing assessment, discharge plans, MDRs, barriers to progression of care, avoidable days, and patient and family needs according to standard work.
Communicates with payors for patient needs for authorization for post-acute care as needed.
Assess patients and families holistically for discharge planning needs in the inpatient, observation and/or emergency departments, including prior functioning, support systems, financial, and psychosocial in a timely fashion to avoid delays in discharge planning.
Reviews the medical record, including medications, history and physical, labs, and progress notes and incorporates the clinical, social, and financial factors into the transition of care plan.
Develops discharge plans with appropriate contingency plans throughout the hospital stay to ensure timely care coordination and progression of care, making arrangements for post-acute care services and facilities as well as community care for social needs.
Leverages technology and follows standard work and best practices to communicate with post-acute care services and facilities to ensure patient care information is communicated for continuity of care, medical records are complete, and discharge reconciliation is accurate.
Other duties as assigned.
Qualifications
Associate's of Nursing Required
Bachelor's of Nursing Preferred
Two or more years of Work Experience Required
Hospital case management experience preferred
Leadership skills
Process and Outcome data analysis skills
Critical thinking and problem-solving skills
Ability to manage multiple tasks and prioritize levels of importance
Customer service skills
Ability to work and communicate with people of all social, economic, and cultural backgrounds; be flexible, open-minded and adaptable to change
Effective organizational skills
Computer proficiency with Outlook e‑mail and electronic medical records
Flexible in a complex and changing healthcare environment
Knowledge of community resources and post‑acute care programs across the continuum
Knowledge of clinical and social factors that affect the patients functional status at discharge
Knowledge of CMS Conditions of Participation for Discharge Planning
Conflict management and resolution skills
Teamwork principles
Registered Nurse (RN) Required
Certified Case Manager (CCM) Preferred
Accredited Case Manager (ACM) Preferred
EEO Statement
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.