Registered Nurse (RN) Case Manager 3

About the role

Inova Fairfax Hospital is seeking a dedicated, experienced Registered Nurse Case Manager 3 to join the Case Management team. Inova is consistently ranked a national healthcare leader in safety, quality, and patient experience.

Responsibilities

• Develops, implements and evaluates patient care plans and progression throughout the continuum of care or disease state.
• Provides discharge planning and continuity of care for assigned patients in the acute and post-acute setting.
• Initiates and facilitates referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated.
• Collaborates with the interdisciplinary healthcare team, patients and families in the assessment and coordination of discharge planning needs, delivery of post-discharge planning needs, delivery of post-discharge services and transition of patients from hospitals to the discharge setting as well as ongoing care in the community.
• Documents relevant discharge planning information in medical records according to department standards and/or care management plans.
• Collects delay and other data for specific performance and/or outcome indicators.
• Affixes referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated.
• Collaborates/communicates with internal and external case managers. Understands pre-acute and post-acute resources. Provides coordination of services and acts as a key Liaison between patients, families and the interdisciplinary healthcare team members.
• Works closely with members of patients' healthcare teams to manage and coordinate all areas of patients' care. Works holistically to ensure that healthcare plans and discharge plans meet the physical, social and emotional needs of patients.
• Provides educational resources and/or referrals to patients and patients' families to address identified needs such as social or financial.
• Acts as an advocate for patients to resolve barriers to care progression.
• Uses utilization management techniques to determine the medical necessity, appropriateness and efficiency of the use of healthcare services, procedures and facilities.
• Communicates with payers or required parties to ensure reimbursement certification for assigned patients.
• Applies approved clinical criteria to monitor appropriateness of admissions, continued stays or post-acute setting appropriateness and documents findings based on department standards.
• Identifies at risk populations by using approved screening tools and following established reporting procedures.
• Maintains LOS and ancillary resource use, depending on inpatient stay or outpatient program criteria, on an ongoing basis and takes actions to achieve continuous improvement efficiencies in both areas.
• Refers cases and issues appropriately to resolve barriers to care progression.
• Assesses patients' clinical and psychosocial needs through review of patient information, personal contact with patients/families and interdisciplinary healthcare team members.
• Communicates routinely with patients, families, interdisciplinary healthcare team members and other appropriate parties with regard to the status of patients' care plans and progress toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict resolution when necessary.
• Works with the multidisciplinary team to address/resolve system problems impeding diagnostic or treatment progress.
• Sets up consultations with appropriate disciplines/departments as required to expedite care and facilitate discharge.
• Ensures that all elements critical to patients' care plans have been communicated to the patients/families and members of the healthcare team.

Qualifications

• Basic Life Support
• Licensed or eligible for licensure in the Commonwealth of Virginia as a Registered Nurse
• 4 years of case management and/or clinical care experience
• Bachelor's Degree in Nursing

Skills

• Strong clinical expertise and utilization management techniques
• Excellent communication and collaboration skills
• Ability to work independently and as part of a team
• Knowledge of healthcare regulations and compliance

Benefits

Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.

Retirement: Inova matches the first 5% of eligible contributions – starting on your first day.

Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.

Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.

Work/Life Balance: offering paid time off, paid parental leave