RN Case Manager

Reports to the Manager or Director of Case Management. Provides coordinated care support to facilitate and expedite patient care services. Participates in daily rounds and collaborates with the clinical healthcare team across the patient care continuum, including pre‑admission and post‑hospital discharge. Shares responsibility for implementing the discharge plan and ensures efficient delivery of patient care through appropriate utilization of healthcare resources. Full‑time, part‑time, per‑diem, and job‑share schedules are available. Employees are expected to role‑model the organization’s values of Compassion, Accountability, Respect, and Excellence, and to demonstrate the Core Success Factors: Instill Trust and Value Differences, Patient and Community Focus, and Collaborate.

Responsibilities

• Partner with medical staff and other members of the healthcare team, in collaboration with the patient/family, to facilitate the plan of care for a defined patient population across the continuum of care.
• Identify a high‑risk patient population within the caseload for care‑management assessment, screening, and targeted interventions within one business day of admission.
• Participate in daily care rounds to collaborate with the patient’s healthcare team and to evaluate and facilitate development and implementation of the discharge planning process.
• Develop the initial patient discharge plan and review it with the patient, family members, and the interdisciplinary team.
• Reassess the discharge plan daily during collaborative care rounds.
• Proactively build post‑hospital referrals and send them to the Transition Care Coordinator when indicated to facilitate timely discharge.
• Deliver important‑message follow‑up notices to all Medicare patients according to CMS regulations.
• Follow CMS and DOH regulations related to discharge guidelines and patient rights.
• Coordinate length of stay with the physician care team and patient.
• Ensure the team is informed of insurance qualifiers that may affect the discharge plan.
• Discuss approaching discharge readiness of patients.
• Identify and assess readmitted and complex patients in collaboration with the healthcare team to coordinate discharge.
• Advocate for the patient and advise regarding financial implications of the discharge plan.
• Communicate the discharge plan, including post‑facility acceptance, to patients, families, and all members of the care team.
• Document final discharge disposition in progress notes.
• Develop appropriate patient‑care reports to ensure safe handovers as patients are transferred between care areas.
• Provide care‑plan direction that supports managed‑care strategies and decreases readmission risk.
• Act as a change agent by identifying opportunities to improve patient flow and reduce service delays through problem resolution and follow‑up.
• Demonstrate a fundamental grounding in nursing theory and practice with a clinical background within a defined content area.
• Remain current on the latest concepts, techniques, and methods relative to the service.
• Demonstrate knowledge of federal and state rules and regulations.
• Identify and track service and discharge patient delays.
• Participate in departmental and/or interdepartmental quality‑improvement activities (e.g., OpX teams, weekly long‑LOS reviews, interdisciplinary rounds, readmission reviews).
• Participate in orienting new staff as requested.
• Engage in ongoing education‑related professional activities and affiliations to maintain an advanced level of knowledge of patient‑care services, third‑party payer, managed‑care requirements, and case management.

Minimum Qualifications

• Licensure as a Registered Nurse in the State of Rhode Island by the Rhode Island Board of Nursing, or licensure in accordance with the Nurse Licensure Compact.
• Graduate of a School of Nursing with a current RN license in Rhode Island.
• Bachelor’s Degree required.
• Certification in Case Management by a nationally recognized organization preferred.
• AHA BLS Provider required.
• Three years of clinical experience with recent experience in case management, community case management, patient navigation, or discharge planning strongly preferred.
• Strong analytical and interpersonal skills to provide guidance and communicate daily with healthcare professionals, patients, and families.
• Collaborative communication approach with a diverse population of providers, insurers, patients, and families.
• Knowledge and skills to provide care across the lifespan, considering aging processes, human development stages, and cultural patterns.
• Proficiency in Microsoft Office, email, Outlook calendar, and basic keyboarding skills.

Work Environment and Physical Requirements

• General hospital environment with occasional stressful conditions associated with patient care.
• Risk of exposure to blood‑borne pathogens minimized by adherence to hospital infection‑control policies.
• Must be able to make hospital rounds through various patient‑care areas by walking or other mobile means.
• Visual acuity and finger dexterity needed to review medical records, navigate automated system screens, and type on a computer keyboard.
• Ability to lift up to 10 lb may be necessary to transport items between care units.
• Independent action: responds to individual patient‑care situations using knowledge and skills acquired through education, certification, and experience.
• Supervisory responsibility: none.

Pay

$90,417.60 – $146,640.00

Schedule

Work Type: 8:00 AM – 4:30 PM, rotating weekends and holidays.

Location: Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903.