RN Case Manager

RN Case Manager Schedule: Monday–Friday, usually 8‑hour shifts. Current call matrix is rotating call. Job Location: In Person. Responsibilities Complete documentation per workflow timeline and content requirements, including the Individual Plan of Care per CMS guidelines. Schedule family conferences and/or communicate with caregivers following each team conference and as needed to keep the patient and designated caregiver informed of progress and provide information related to goal achievement, course of rehabilitation, and discharge plans. Coordinate weekly patient care team conferences to develop, monitor and refine treatment plans to achieve identified patient goals and outcomes. Review the patient’s assigned CMG and identify potential missed comorbid conditions actively being treated during the patient’s stay; communicate findings to the HIM team. Assist with concurrent and retrospective utilization review activities including denials and appeals. Work with physicians to conduct peer review with payer medical director when indicated. Ensure clinical updates are provided to all insurance payers when due and document all payer communications in Meditech. Coordinate 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. Ensure a thorough discharge plan, offer and document patient choice as per CMS Conditions of Participation. Identify trends that impact quality, cost effectiveness, patient experience and delivery of care services; report findings at departmental leadership meetings. Perform intake assessment on patient within 24–72 hours of admission, preferably within 48 hours. Perform follow‑up assessments per Case Management Plan and/or hospital policy. Qualifications Current VA RN license or compact state license. Bachelor’s degree preferred (not required). Experience in acute care hospital preferred. Benefits Comprehensive benefits: multiple levels of medical, dental and vision coverage; tailored benefit options for part‑time and PRN employees. Financial protection and paid time off: life, accident, critical illness, hospital indemnity insurance, short‑ and long‑term disability, paid family leave and paid time off. Career growth: higher education and certification tuition assistance, loan assistance, and 401(k) retirement package with 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. 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