RN Case Manager

RN Case Manager Schedule: Monday-Friday usually 8-hour shifts Current call matrix is rotating call. Job Location Type: In Person Your Experience Matters Sovah Health – Danville is part of Lifepoint Health, a nationally recognized healthcare network committed to making communities healthier. We prioritize your well‑being so you can deliver exceptional care to every patient. More About Our Team Our Case Management team focuses on serving the adult population in our community, maintaining a patient‑to‑staff ratio that is below the national average. Our collaborative approach to safe, effective discharge planning includes close coordination between a Utilization Review RN, Case Manager RN, and Social Worker—ensuring each patient receives comprehensive, personalized support throughout their care journey. How You’ll Contribute Completes documentation per workflow timeline and content requirements, including completion of the Individual Plan of Care (IPoC) per CMS guidelines. Schedules family conferences and/or communicates with caregiver following each team conference and more often as needed to keep patient and designated caregiver informed of progress and provide appropriate information related to goal achievement, course of rehabilitation stay, and plans for discharge. Coordinates weekly patient care team conferences to facilitate development, monitoring and refinement of treatment plan to achieve identified patient goals and outcomes. Reviews the patient’s assigned CMG and helps the team identify any potential missed comorbid conditions that are actively being treated during the patient’s stay. Communicates any findings to the HIM team. Assists with concurrent and retrospective utilization review activities including denials and appeals. Works with physicians to conduct peer review with payer medical director when indicated. Ensures clinical updates are provided to all insurance payers when due and all payer communications are documented in Meditech. Coordinates discharge planning needs including but not limited to home health services, physician follow up care, durable medical equipment, medical supplies, healthcare services, outpatient therapy, dialysis, skilled nursing care, assisted living care, hospice care, private duty care, etc. Responsible for coordinating all patient care needs prior to discharge ensuring a safe thorough discharge plan. Ensures patient choice is offered and documented as per CMS’ Conditions of Participation for Discharge Planning. Identifies trends that impact the quality, cost effectiveness, patient experience and delivery of care services and brings them to departmental leadership meetings for discussion and action. Performs intake assessment on patient within 24 to 72 hours of admission, preferably within 48 hours. Performs follow‑up assessments per Case Management Plan and/or hospital policy. Why Join Us We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: Comprehensive Benefits: Multiple levels of medical, dental and vision coverage, tailored benefit options for part‑time and PRN employees, and more. Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short‑ and long‑term disability, paid family leave and paid time off. Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match. Employee Well‑being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs). Professional Development: Ongoing learning and career advancement opportunities. What We’re Looking For The right candidate will coordinate management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Serves as a patient advocate through resource utilization, discharge planning and addressing the holistic needs of the patient. Applicants should have a current VA RN license or compact state. Bachelor’s degree preferred but not required. Experience in acute care hospital, preferred. EEOC Statement Sovah Health – Danville is an Equal Opportunity Employer. Sovah Health – Danville is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment. #J-18808-Ljbffr