Registered Nurse Case Manager

Provide discharge planning and continuity of care for assigned patients in acute and post-acute settings Coordinate services and act as a liaison between patients, families, and interdisciplinary healthcare team members Initiate and facilitate referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment, and supplies Coordinate discharge planning, post-discharge services, and patient transitions from hospitals to discharge settings and ongoing community care Collect, analyze, and address delay, outcome, resource, financial, variance, and utilization data Document clinical path variances, discharge planning information, findings, and patient care information in medical records Collaborate with internal and external case managers, physicians, clinical staff, payers, patients, families, and multidisciplinary teams Provide education and referrals addressing patients' social and financial needs Advocate for patients and resolve barriers to care progression Apply utilization management and approved clinical criteria to assess medical necessity, admissions, continued stays, and post-acute appropriateness Identify at-risk populations, monitor length of stay and resource utilization, and drive continuous improvement Assess patients' clinical and psychosocial needs and communicate care-plan progress, concerns, and problems Seek consultations and resolve system problems impeding diagnostic or treatment progress Perform other duties as assigned Requirements Basic Life Support certification from the American Heart Association Licensed or eligible for licensure in the Commonwealth of Virginia as a Registered Nurse, or an active multi-state Registered Nurse license 1 year of case management and/or clinical care experience Bachelor's Degree in Nursing or Associate's Degree Associate's Degree holders must identify an accredited school, provide a written BSN completion plan, submit transcript and prerequisite/timeline review, and complete the BSN within 5 years of starting Ability to provide discharge planning and continuity of care in acute and post-acute settings Knowledge of utilization management, medical necessity, payer criteria, precertification, and authorization processes Ability to assess clinical and psychosocial needs and coordinate interdisciplinary care Ability to document patient care, discharge planning, variances, and outcomes according to department standards Ability to work Monday through Friday with rotating weekends and holidays Core Competencies Demonstrates expertise in discharge planning and continuity of care, with a strong focus on assessing clinical and psychosocial needs while coordinating interdisciplinary care. Proficient in utilization management and documentation of patient care outcomes in acute and post-acute settings. Highest-signal resume keywords Discharge Planning Utilization Management Clinical Care Assessment Case Management Experience Basic Life Support Certification ATS Optimization Keywords Hard Skills Discharge Planning Utilization Management Clinical Care Assessment Documentation of Patient Care Data Analysis Referral Coordination Patient Advocacy Interdisciplinary Collaboration Outcome Measurement Resource Utilization Soft Skills Communication Problem Solving Advocacy Collaboration Education Certifications & Qualifications Basic Life Support Certification Registered Nurse License Industry Keywords Acute Care Post-Acute Care Patient Transitions Medical Necessity Payer Criteria Precertification Authorization Processes Clinical Path Variances Social Needs Assessment Financial Needs Assessment #J-18808-Ljbffr Jobtailor