Case Management Program Manager (Registered Nurse OR Social Worker)

Case Management Program Manager (Registered Nurse OR Social Worker) Alexandria, VA, United States Full time, Monday–Friday 8:30 am–5:00 pm with weekend rotations. Benefits Committed to Team Member Health: medical, dental, and vision coverage and a robust wellness program. Retirement: Inova matches the first 5 % of eligible contributions starting on your first day. Tuition and Student Loan Assistance: up to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: 25 mental‑health coaching or therapy sessions per person per year, at no cost. Work/Life Balance: paid time off, paid parental leave, and flexible work schedules. Responsibilities Serve as a resource for discharge planners and the multidisciplinary team through guidance, training, consultation, participation in multidisciplinary rounds, and patient assignment management. Ensure continuity of care by reviewing patient assessments, arranging referrals for social determinants of health, and identifying at‑risk populations. Initiate and facilitate referrals to specialists, clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment, and supplies as needed. Maintain routine communication with patients, families, interdisciplinary members, and others about care plans, progress, concerns, problem solving, conflict resolution, and documentation. Seek timely consultation from appropriate disciplines or departments to expedite care and facilitate discharge. Communicate with payers to ensure reimbursement certification, discuss payer criteria, and resolve payer issues. Collaborate closely with discharge planners and healthcare teams to manage and coordinate all areas of care. Adhere to policies, procedures, and standards within budgetary specifications and productivity benchmarks. Collect and report resource and financial indicators, including clinical metrics, case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials, and appeals. Serve on agency committees, work groups, and other bodies. Lead quality assurance for service delivery, addressing variances from plans of care and performance indicators. Perform additional duties as assigned. Minimum Requirements Education: Bachelor’s Degree in Nursing or Master’s Degree in Social Work. Experience: Minimum of five years in acute‑care case management within an acute healthcare environment, with demonstrated understanding of discharge planning and social determinants of health. License: If an RN, licensed in the Commonwealth of Virginia. Certification: Basic Life Support (BLS) for Healthcare Provider; either Accredited Case Manager (ACM) or Certified Case Manager (CCM) upon start. Preferred Qualifications Five or more years of inpatient case‑management experience, discharge‑planning and supervisory/lead experience, with exposure to medically complex cases. Equal Opportunity Statement Inova Health System is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, pregnancy (including childbirth, pregnancy‑related conditions and lactation), race, religion, sex, sexual orientation, veteran status, genetic information, or any other characteristics protected by law. #J-18808-Ljbffr Case Management Society of America Inc