Registered Nurse (RN) Case Manager - MAryview Medical Center

At Bon Secours Mercy Health, we are dedicated to continually improving health care quality, safety and cost effectiveness. Our hospitals, care sites and clinicians are recognized for clinical and operational excellence.

About Us

As a faith-based and patient-focused organization, Bon Secours exists to enhance the health and well-being of all people in mind, body and spirit through exceptional patient care. Success in this goal requires a culture of compassion, collaboration, excellence and respect. Bon Secours seeks people that are committed to our values of compassion, human dignity, integrity, service and stewardship to create an environment where associates want to work and help communities thrive.

Job Summary :

The RN Care Manager is responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. This role utilizes a collaborative process, the RN Care Manager identifies (using quantitative and qualitative methods), assesses, plans, implements and evaluates the options and services required to meet an individual's health and health related needs, including social- determinants that affect ones' overall wellbeing. The RN Care Manager is responsible for screening, identification, and assessment of individuals in need of active Case Management services and promotes the right resources, at the right time and at the right place.

Essential Functions :

• Identifies and prioritizes patients in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors. Plans with the patient, caregivers and members of the healthcare team to maximize health care responses, quality and cost-effective outcomes. Monitors and revises the plan as indicated when patient condition changes.
• Completes all necessary documentation. Maintains, clear, concise, and timely documentation in the patient record to reflect the needs of the patients. Handovers are expected to be utilized at points of level of care change, staff change, as well as care transitions.
• Documentation will reflect plan of care to address post hospital care needs and resources and evidence of patient, family or caregiver involvement in planning. Ensuring patient's and caregiver's treatment goals and preferences are incorporated into the transition of care planning and communicated to the multidisciplinary team.
• Follow standardized practices and process related to Advance Care Planning, Length of Stay management and readmission prevention.
• Supports denial prevention related to medical necessity through addressing / removing barriers to progression of care and participating in Interdisciplinary Discharge Rounds.
• Supports and promotes assertive, proactive care for patients, assisting in removing barriers related to achieving timely testing and treatment. Ensures resources are utilized appropriately and offering alternatives to acute care to the care team.

Education :

Licensure / Certification :

Experience :

Training : None

Skills and Abilities :

Hard / Tech / Clinical Skills

Care management

Discharge planning

Patient Advocacy

Flexible

Care Planning

Care Coordination

Analyzing data or information

Reimbursement methodologies

Staffing workflow and bed allocation

Clinical knowledge

Tracking

Working knowledge of local and state resources

Knowledge of government and non-government payor practices, regulations, standards and reimbursement

Soft / Interpersonal Skills :

Knowledge Sharing

Attention to detail

Critical thinking

Communication with family members

Conflict resolution

Proactive

Problem Solving

Active listening

Relationship building

Effective problem solving

Teamwork

Facilitation

As a Bon Secours Mercy Health associate, you're part of a Mission that matters. We support your well-being—personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.

What We Offer

Benefits may vary based on the market and employment status.

All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Bon secours Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email recruitment@mercy.com. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com