Registered Nurse RN Case Manager

Description

SHIFT: Days (rotating weekends)
SCHEDULE: Full-time


 

LewisGale Hospital Montgomery (LGHM) is located in the beautiful mountainous region of Virginia. Montgomery is located in the backyard of the Virginia Tech University campus.  LGHM is a HCA (Hospital Corporation of America) hospital and are considered a 146-bed acute care facility. Most importantly, we hold a distinction for being a Magnet Facility and are recognized by the Joint Commission as a Top Performer.  Consider being a part of making a difference in our community by joining our facility!

 
Responsibilities of the Case Manager
  • Performs a comprehensive assessment of psychosocial and medical needs of assigned patients
  • Develops a case management plan of care to include identified clinical, psychosocial and discharge needs; coordinates plan of care; plan is documented in the medical record; plan is communicated to appropriate clinical disciplines.
  • Assumes a leadership role with the interdisciplinary team to manage care, through criteria driven processes, for the appropriate level of care, patient status and resource utilization
  • Conducts interdisciplinary team meetings to provide a mechanism for all clinical disciplines to collaborate, plan, implement, and assess the plan of care; patient selection should be criteria based and interventions will be documented 
  • Evaluates admissions for medical necessity using approved criteria at defined intervals throughout the episode of care; escalates medical necessity  and admission status issues through the established chain of command
  • Evaluates and assess observation patients for appropriateness in observation status
  • Performs utilization management reviews and communicates information to third party payers
  • Acts as a liaison through effective and professional communications  between and with physicians, patient / family, hospital staff, and outside agencies
  • Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives; monitors self-compliance and implements process changes to ensure compliance  to such regulations and quality initiatives as it relates to the provision of Case Management Services
  • Makes appropriate referrals to third party payer disease and case management programs for recurring patients and patients with chronic disease states
  • Documents professional recommendations, care coordination interventions, and case management activities to effectively communicate to all members of the health care team
  • Facilitates patient throughput with an ongoing focus on quality and efficiency
  • Tracks and trends barriers to care;  makes recommendations and develops action plans to improve processes and systems
  • Involves patient, family/responsible/significant others in identifying and clarifying needs and expectations to develop mutual and realistic goals
  • Assesses patients’ post discharge needs and facilitates the provision of services necessary to meet identified needs
  • Actively seeks ways to control costs without compromising patient safety, quality of care or the services delivered
  • Identifies patients with the potential for high risk complications and makes appropriate referrals acting as an advocate for the individual’s healthcare needs
  • Directs activities to identify and provide for the needs of the under resourced patient population to include patient education activities, patient assistance programs, and community based resources
  • Develops individual plans of care for recurring patients to include education on appropriately accessing healthcare resources, preventative education, and community based resources 
  • Assumes a leadership role in the development, revision, and implementation of clinical protocols  which transition patients across the continuum of care or discharge patients to an appropriate service level of care
  • Tracks and trends variances to care and barriers to care;  makes recommendations and develops  action plans to improve processes and systems
  • Adheres to established policy and procedure and standards of care;  escalates issues through the established Chain of Command timely

Qualifications

EXPERIENCERequired - Three years of experience in the healthcare field in specialty areas. Possesses knowledge of utilization review, and discharge planning. Basic computer skills.
EDUCATION REQUIRED AND/OR PREFERRED:
  • Diploma or Associates Degree from a professional nursing program (required)
  • BSN or current enrollment in a BSN program at an accredited school of Nursing (preferred)
LICENSURE/CERTIFICATION:
  • Current Registered Nurse License in this state
  • American Heart Association Basic Life Support (BLS) Health Care Provider (required)
  Why join HCA - LewisGale? 
  • Matching 401K
    • Low Deductibles for Health, Vision, and Dental
    • Team Culture
    • Passion for patient care
    • Career Advancement through Clinical Ladder
    • Relocation Assistance
    • Tuition Reimbursement Program ($5,250/calendar year)
    • Student Loan Assistance Program ($1,800/calendar year)
 

We are an equal opportunity employer and we value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.”

     

Notice

Our Company’s recruiters are here to help unlock the next possibility within your career and we take your candidate experience very seriously. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Gmail or Yahoo Mail. If you feel suspicious of a job posting or job-related email, let us know by clicking here.

For questions about your job application or this site please contact HCAhrAnswers at 1-844-422-5627 option 1.

Posted
06/08/2021
Location
Blacksburg, VA 24060, US