RN Case Manager - Weekends

Job Title: RN Case Manager - Weekends

Employment Status: Full time

Shift: Day/Evening (United States of America)

Facility: 1906 Belleview Ave SE - Roanoke CP01 Carilion Medical Center.

Requisition Number: R RN Case Manager - Weekends (Open)

How You'll Help Transform Healthcare: Full time and Part time options - Friday/Saturday/Sunday or Saturday/Sunday/Monday: Three 12 hour shifts. Sign on bonus and relocation assistance available.

The RN Case Manager provides case management for assigned patient populations, utilizing clinical expertise, communication, and problem‑solving skills to achieve optimal clinical and resource outcomes. This role promotes cost‑effective care by minimizing fragmentation, maximizing coordination, and facilitating patient/family movement through the health care organization. Responsibilities include performing patient needs assessments upon admission and at regular intervals, facilitating referrals, and providing linkages to health, wellness, and post‑acute care resources across the continuum. The RN Case Manager promotes interdisciplinary collaboration and teamwork to progress the plan of care and discharge plan, manages appropriate length of stay, resource management, and care transitions, and complies with all federal and state regulations surrounding the discharge process. Knowledge of growth and development appropriate to the age group served and incorporating this into the plan of care is required.

• Collaborates with Utilization Review Nurse and maintains regular contact throughout the day.
• Uses InterQual software to support accurate patient statuses according to ongoing medical necessity.
• Aids in the delivery of regulatory letters and patient notices related to insurance coverage/non‑coverage, using support staff as appropriate.
• Ensures documentation accurately reflects the patient’s condition, co‑morbidities, treatment, and procedures that support the most appropriate admission status and DRG assignment.
• Communicates with patients/families to ensure understanding of financial implications of discharge plans.
• Facilitates an interdisciplinary approach to patient care and actively participates in Interdisciplinary Team Meetings on assigned units.
• Provides feedback to the health care team verbally and via chart entries regarding the patient’s progress toward expected outcomes or about barriers to the plan, and manages changes as necessary.
• Maintains effective communications with all disciplines to promote timely and appropriate discharges.
• Coordinates care and services within the case‑managed population, performs face‑to‑face assessments of patients/families when appropriate, and reviews assigned census each day with SW partner to determine patient statuses and needs.
• Documents in the medical record within the appropriate time frame, accurately reflecting the plan of care and CM interventions, and complies with CMS regulations related to discharge planning documentation.
• Coordinates referrals of post‑acute services such as home health, hospice, and durable medical equipment (DME); directs liaison activities to integrate the patient into the health care continuum.
• Facilitates appropriate referrals surrounding high‑cost medications for all patients, insured or uninsured, and obtains prior authorizations and co‑pay information to ensure medication needs are met for discharge.
• Ensures coordination of care when patients are transferred (acute hospital to acute hospital, and jails/prisons) and communicates with outside nursing or case management staff for smooth transition.
• Advocates for the patient and family throughout the entire episode of care.
• Participates in departmental and system performance improvement initiatives and contributes to Carilion Clinic’s performance improvement activities by engaging predictive analytic software.
• Collects and analyzes relevant patient care and fiscal data, evaluates the effect of case management on quality outcomes and fiscal parameters, and complies with all departmental policies while fostering teamwork and professionalism.
• Participates in unit‑based IDR morning and afternoon huddles, coordinates referrals for DME, HH, hospice, utilizes predictive analytic software, and completes face‑to‑face patient assessments.
• Communicates with assigned UR nurse and SW partner, reassesses patients, documents status of referrals, and addresses barriers.
• Aids in the delivery of regulatory letters and integrates InterQual information during unit huddles and throughout the workday.
• Provides medication assistance to patients identified in need (RX Help, CMAP) and initiates medication investigations for authorization and co‑pay information.
• Communicates post‑acute care needs of inmates during transitions back to jail and assists in acute‑acute and transitions of care.
• Maintains awareness and anticipates unit‑based patient needs, providing hand‑off communication of unit needs to peers during weekday/weekend transitions.

What We Require:

Education: Registered Nurse. Bachelor's degree required. Five years of RN experience in a hospital setting may be considered in lieu of a bachelor's degree.

Experience: Three years of recent experience in a clinical health care setting with responsibilities reflecting direct management of patient care including planning, coordination, and delivery of needed services such as education, psychosocial support, discharge planning, and utilization management. Supervisory or leadership experience is preferred.

Licensure: Current licensure in Virginia as a Registered Nurse.

Life Support: AHA BLS‑HCP required within 6 months of hire.

Other Minimum Qualifications: Demonstrated knowledge and competency in orientation completion; effective oral and written communication skills; integrity, innovation, teamwork, courtesy, complaint resolution, customer‑focused service delivery, willingness to work in a multidisciplinary team; computer literacy, knowledge of community and system resources, interpersonal relations, assertiveness, flexibility, perseverance, diplomacy, and negotiation.

This job description is a representative summary of the major responsibilities and accountabilities performed by the incumbents of this job. Incumbents may be requested to perform job‑related tasks other than those stated in this description.

Compensation Range:

$76,689.60 – $115,044.80

Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan.

Benefits, Pay and Well‑being at Carilion Clinic

Carilion understands the importance of prioritizing your well‑being to help you develop and thrive. We offer a well‑rounded benefits package and many perks and well‑being resources to help you live a happy, healthy life at work and when you’re away.

• Comprehensive Medical, Dental, & Vision Benefits
• Employer‑Funded Pension Plan, vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• On‑site fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app, Personify Health
• Childcare discounts
• Continued education and training

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug‑Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process, contact Carilion HR Service Center at 800‑599‑2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.

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