RN Case Manager - Care Management

Job Description

Description

At Peacehealth, it's our vision that every person receives safe, compassionate care; every time, every touch. As a RN Case Manager at Southwest Medical Center, you’ll be part of a healthcare team working together to provide our patients, and their families, the support and care they need from diagnosis to discharge.

In this full-time RN Case Manager position you will work 8-hour Day shifts, 40 hours per week in our Care Management department.

What we offer:

• Hourly compensation is $45.30 - $71.12; hiring rate dependent on qualifications and professional experience and/or terms of Collective Bargaining Agreement

• Additional pay for BSN, MSN, DPN, and specialty nursing certification
• A Hiring Bonus is available
• Student Loan Repayment Program
• Relocation Assistance
• Comprehensive benefits package, effective the first of the month following your start date
• A hospital on the Magnet Journey

PeaceHealth is a non-profit mission driven healthcare system serving communities in Washington, Oregon, and Alaska. Located in Vancouver, PeaceHealth Southwest Medical Center and our Medical Group provide comprehensive specialty care for more than 280,000 patients annually in southwest Washington. One of Clark County’s largest employers, PeaceHealth Southwest is a 450-bed acute care hospital, with level II trauma center, that offers dozens of medical specialty services and programs.

For additional information or questions, feel free to reach out to the recruiter at [email protected]

Must be fully vaccinated for COVID-19 including 2 doses of a 2-dose series or 1 dose of a 1-dose series plus 14 days beyond the final dose prior to start date.

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Position Details:

1. Provide initial and ongoing assessments of the patients’ needs for services in collaboration with the healthcare team. Monitor and evaluate utilization of those services to focus on the best treatment and approach for the patient promoting the timely progression of interventions, utilization of resources and expected outcomes within a length of stay consistent with external regulations and standards.
2. Provide utilization management including facilitating appropriate status assignment per Medicare and InterQual criteria. Ensure appropriate documentation for medical necessity of admission and continued hospitalization. Ensure appropriate level of care bed assignment, apply/interpret payer criteria to ensure conformance with payer standards and provide insurance reviews. Implement opportunities to improve effectiveness in utilization.
3. Provide transition planning coordination to include identifying needs and implementing referrals to other clinical care providers. Evaluate patient progress and revise the care plan if needed. Act as a resource for physician office, physician and staff regarding Intensity Severity Discharge (ISD) criteria. Identify barriers to achieving patients discharge and assist the care team in overcoming them.
4. Provide patient/family education to facilitate an understanding of their hospital and post-hospital course, their status assignment and discharge appeal rights and provide advocacy for their care.
5. Effectively communicate and provide clear and concise documentation according to department standards and regulatory requirements. Refer to appropriate internal and community resources as necessary.
6. Act as care management resource by demonstrating critical thinking, portraying a professional image of competency to customer and staff and demonstrating effective verbal and written communication with everyone. Maintain knowledge of CMS, Medicaid, and regulatory agency standards, Department of Health (DOH), Emergency Medical Treatment and Active Labor Act (EMTALA). Serve as a clinical resource and/or liaison.
7. Lead “progression of care” transition rounds, assigning cases to MSW/Discharge planner for intervention.

What you bring:

• Graduate of an accredited school/college of nursing and ability to successfully pass a clinical competency exam.
• WA State RN Licensure 
• American Heart Association Basic Life Support (BLS) for Healthcare Providers required upon hire.
• Minimum three years in a hospital setting with medical/surgical experience with supervisory/preceptor experience (or may have equivalent combination of education and/or experience).
  

OTHER SKILLS:

• Strong verbal, written and interpersonal communication skills.
• Extensive knowledge of diseases, clinical procedures, treatment, prognosis and hospital functions.
• Ability to effectively communicate clinical information.
• Strong analysis/problem solving skills.
• Skill in the evaluation of quality and appropriateness of care.
• Proven leadership ability. Strong organization skills with the ability to work in a fast-paced environment independently or as part of an interdisciplinary team.
• Computer skills to include proficiency in keyboarding and data entry.
• Critical thinking skills, able to assess, evaluate and teach.
• Knowledge of discharge planning, health care reimbursement, utilization review processes and Medicare admission status/classification level.

SOUTHWEST PHYSICAL/COGNITIVE REQUIREMENTS

• Work requires normal exertion at least 66% of the time.
• Ability to lift objects weighing 10 lbs. or less.
• Work is performed under normal working conditions with adequate lighting and ventilation. Reasonably anticipated exposure to blood and body fluids.
• Job duties frequently require intense concentration and attention to detail (34-65% of work time).

This position is represented by a collective bargaining agreement. There may be more than one opening on this posting.

Benefits Eligible Statement: PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

See how PeaceHealth is committed to Inclusivity, Respect for Diversity and Cultural Humility.

For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state, or federal laws.