Job Overview
Weekend Case Management RN responsible for comprehensive transition and discharge planning for targeted patient populations. Works collaboratively with the multidisciplinary care team to facilitate achievement of desired treatment outcomes.
Minimum Qualifications
Current licensure as a Registered Professional Nurse with the WV Board of Registered Professional Nurses or appropriate state board, OR multi‑state licensure through the Nurse Licensure Compact (eNLC).
Three (3) years of clinical experience.
Preferred Qualifications
Bachelor’s degree in Nursing (BSN).
Core Duties and Responsibilities
Manage all aspects of transition/discharge planning for assigned patients in a timely manner.
Collaborate with multidisciplinary team to facilitate transition/discharge process for designated caseload.
Monitor patient progress and intervene as necessary to ensure patient‑focused, high quality, efficient, and cost‑effective care.
Provide education to staff, physicians, and families ensure effective transition planning.
Meet with patient/family to assess needs and develop individualized transition/discharge plan in collaboration with physician team.
Communicate complex family dynamics that may impact patient care and transition/discharge planning with multidisciplinary team and post‑acute providers.
Initiate and facilitate referrals to post‑acute services (Homecare, Durable Medical Equipment, Hospice Care, Long‑Term Acute Care Facilities, Acute Rehab Facilities, Skilled Nursing Facilities).
Communicate transition/discharge plan to multidisciplinary team, patient, and family.
Provide timely and comprehensive documentation of interactions and transition/discharge planning activities according to departmental policy.
Assist patients/families with completion of medical power of attorney, health care surrogate, and advanced directives.
Collaborate for appropriate resource and financial management (financial assistance coordination, entitlement program coordination, patient benefit coordination).
Utilize quality screens in the electronic record to identify potential issues (avoiding delays and readmissions).
Complete clinical reviews for patients.
Apply approved utilization criteria to ensure medical necessity of patient admissions and continued stays, documenting findings based on department standards, policy, and procedure.
Screen for appropriate authorization and level of care.
Facilitate day reimbursement certification for assigned patients and discuss payer criteria and issues on a case‑by‑case basis with clinical staff.
Educate hospital staff and physicians to payer regulations and managed care principles to prevent denials.
Foster integration of staff and/or students into the healthcare team.
Physical Requirements
Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping, and feeling necessary for nursing duties.
Must lift, move, and position patients of all weights with varying amounts of assistance on a regular basis.
Hearing within a normal range required.
Visual acuity within normal range; must perform night driving as necessary for patient care.
Perform heavy work (exerting >100 lbs occasionally, up to 50 lbs frequently, up to 20 lbs constantly).
Working Environment
Working closely with others.
Working protracted or irregular hours.
Working around biohazards.
Working around infectious diseases.
Working with hands in water.
Working with electrical hazards associated with patient care equipment.
Skills and Abilities
Knowledge of patient’s current medical insurance coverage, limitations, and precertification requirements for DME, post‑acute placements, infusions, transfers, etc.
Knowledge of relevant scientific principles, established standards of care, and research findings.
Knowledge of procedures and techniques involved in administering routine and special treatments to patients.
Knowledge of and appropriate application of the nursing process.
Additional Job Information
Weekend Case Management RN, 0.9, 3‑12 hour shifts:
Friday/Saturday/Sunday or Saturday/Sunday/Monday
36 scheduled weekly hours
Weekend shift (United States of America)
Exempt
Company: WVUH West Virginia University Hospitals
Cost Center: 403 WVUH Care Management
Address: 1 Medical Center Drive, Morgantown, West Virginia
Equal Opportunity Employer
West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.