Registered Nurse (RN) or MSW Case Manager - Outpatient Clinic

About the Role

The Case Manager is responsible for the collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective outcomes. Additionally, the Case Manager ensures that identified and referred patients have a coordinated continuum of care in accordance with JCAHO and hospital guidelines and serves as liaison for the interdisciplinary team, the patient, and family to ensure a timely, smooth, and clinically appropriate care planning process. The Case Manager also maintains communications with the payer at the time of admission and throughout the hospitalization to ensure necessary approvals for care and clarification of benefits. They facilitate retrospective reviews and approvals for care whenever necessary, and they implement and coordinate discharge plans utilizing available and appropriate community resources. At VHC Health, every role contributes to exceptional care, better outcomes, and stronger communities.

Responsibilities

• Assess, plan, facilitate, and advocate for options and services to meet individual health needs
• Ensure identified and referred patients have a coordinated continuum of care per JCAHO and hospital guidelines
• Serve as liaison for the interdisciplinary team, patient, and family
• Maintain communications with the payer at admission and throughout hospitalization for approvals and benefit clarification
• Facilitate retrospective reviews and approvals for care as needed
• Implement and coordinate discharge plans using appropriate community resources

Requirements

• Education: Graduation from an accredited school of social work, nursing, in a related field or equivalent is required
• Experience: Five years of experience in the healthcare field is preferred; experience in case management is preferred
• Certification/Licensure: None

Benefits

• Medical, dental, and vision coverage (subject to eligibility requirements)
• Additional wellness and retirement benefits

Pay

Compensation is determined based on qualifications, relevant training and experience, skill level, shift differentials (where applicable), internal equity, and current market conditions. The posted hiring range reflects the range VHC Health believes is appropriate for this role at the time of posting and may be adjusted based on business needs or market changes. Bonuses, incentives, or other benefits are subject to the terms of applicable plans and may be modified at the sole discretion of VHC Health in accordance with applicable law.