RN Case Manager
Company: LewisGale Hospital Montgomery
Location: Blacksburg
Posted on: October 13, 2021
Job Description:
Description
SHIFT: Days (rotating weekends)
SCHEDULE: Full-time
LewisGale Hospital Montgomery (LGHM) is
located in the beautiful mountainous region of Virginia.
Montgomery is located in the backyard of the Virginia Tech
University campus. LGHM is a
HCA (Hospital Corporation of
America) hospital and are considered
a 146-bed acute care facility. Most
importantly, we hold a distinction for being a Magnet Facility and
are recognized by the Joint Commission as a Top Performer. Consider being
a part of making a difference in our community by joining our
facility!
Responsibilities
of the Case Manager
-
Performs a
comprehensive assessment of psychosocial and medical needs of
assigned patients
-
Develops a
case management plan of care to include identified clinical,
psychosocial and discharge needs; coordinates plan of care; plan is
documented in the medical record; plan is communicated to
appropriate clinical disciplines.
-
Assumes a
leadership role with the interdisciplinary team to manage care,
through criteria driven processes, for the appropriate level of
care, patient status and resource utilization
-
Conducts
interdisciplinary team meetings to provide a mechanism for all
clinical disciplines to collaborate, plan, implement, and assess
the plan of care; patient selection should be criteria based and
interventions will be documented
-
Evaluates
admissions for medical necessity using approved criteria at defined
intervals throughout the episode of care; escalates medical
necessity and admission status issues through the established
chain of command
-
Evaluates
and assess observation patients for appropriateness in observation
status
-
Performs
utilization management reviews and communicates information to
third party payers
- Acts as a
liaison through effective and professional communications
between and with physicians, patient / family, hospital staff, and
outside agencies
- Demonstrates
knowledge of regulatory requirements, HCA Ethics and Compliance
policies, and quality initiatives; monitors self-compliance and
implements process changes to ensure compliance to such
regulations and quality initiatives as it relates to the provision
of Case Management Services
- Makes
appropriate referrals to third party payer disease and case
management programs for recurring patients and patients with
chronic disease states
- Documents
professional recommendations, care coordination interventions, and
case management activities to effectively communicate to all
members of the health care team
- Facilitates
patient throughput with an ongoing focus on quality and
efficiency
- Tracks and
trends barriers to care; makes recommendations and develops
action plans to improve processes and systems
- Involves
patient, family/responsible/significant others in identifying and
clarifying needs and expectations to develop mutual and realistic
goals
- Assesses
patients’ post discharge needs and facilitates the provision of
services necessary to meet identified needs
-
Actively
seeks ways to control costs without compromising patient safety,
quality of care or the services delivered
- Identifies
patients with the potential for high risk complications and makes
appropriate referrals acting as an advocate for the individual’s
healthcare needs
- Directs
activities to identify and provide for the needs of the under
resourced patient population to include patient education
activities, patient assistance programs, and community based
resources
- Develops
individual plans of care for recurring patients to include
education on appropriately accessing healthcare resources,
preventative education, and community based
resources
- Assumes a
leadership role in the development, revision, and implementation of
clinical protocols which
transition patients across the continuum of care or discharge
patients to an appropriate service level of care
- Tracks and
trends variances to care and barriers to care; makes
recommendations and develops action plans to improve
processes and systems
- Adheres to
established policy and procedure and standards of care;
escalates issues through the established Chain of Command
timely
Qualifications
EXPERIENCE
Required - Three years of
experience in the healthcare field in specialty areas. Possesses
knowledge of utilization review, and discharge planning. Basic
computer skills.
EDUCATION REQUIRED
AND/OR PREFERRED:
- Diploma or Associates Degree from a
professional nursing program (required)
- BSN or current enrollment in a BSN
program at an accredited school of Nursing (preferred)
LICENSURE/CERTIFICATION:
- Current Registered Nurse License in
this state
- American Heart Association Basic
Life Support (BLS) Health Care Provider (required)
Why
join HCA - LewisGale?
- Matching 401K
-
- Low
Deductibles for Health, Vision, and Dental
- Team Culture
- Passion for patient care
- Career Advancement through Clinical
Ladder
- Relocation Assistance
- Tuition Reimbursement
Program ($5,250/calendar year)
- Student Loan
Assistance Program ($1,800/calendar year)
We are an equal opportunity employer and we
value diversity at our company. We do not discriminate on the basis
of race, religion, color, national origin, gender, sexual
orientation, age, marital status, veteran status, or disability
status.”
Notice
Our Company’s recruiters are here to help unlock the next
possibility within your career and we take your candidate
experience very seriously. During the recruitment process, no
recruiter or employee will request financial or personal
information (Social Security Number, credit card or bank
information, etc.) from you via email. The recruiters will not
email you from a public webmail client like Gmail or Yahoo Mail. If
you feel suspicious of a job posting or job-related email, let us
know by clicking here.
For questions about your job application or this
site please contact HCAhrAnswers at 1-844-422-5627 option
1.
Keywords: LewisGale Hospital Montgomery, Blacksburg , RN Case Manager, Other , Blacksburg, Virginia
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