RN Case Manager (Full-time Day Shift)

Job Description

Description

Join our Care Management team in this rewarding career collaborating with an interdisciplinary healthcare team to assess and coordinate our patients' needs for services and plan for discharge. We are seeking a RN Case Manager for a full-time position in the Care Management department at Southwest Medical Center in Vancouver, Washington.  This is a 1.0 FTE Day shift position working 8-hour shifts, 40 hours per week.

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
• Hiring Bonus
• Student Loan Repayment Program
• Relocation Assistance is available
• Comprehensive benefits package that includes three medical plans options, a retirement plan with employer matching and base contributions, excellent tuition reimbursement, CE, a wellness program and so much more!
• Non-Profit mission-drive healthcare system

Southwest Washington Medical Center is a 450-bed tertiary-level hospital, located just across the river from the Portland [Oregon] metropolitan area. Vancouver is a great location where you can enjoy big city life or the serene countryside, with easy access to an abundance of recreational and cultural activities. Located just across the river from the Portland [Oregon] metropolitan area, Vancouver is a great location where you can enjoy big city life or the serene countryside, with easy access to an abundance of recreational and cultural activities.

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.
8. For Emergency Department Case Manager role: coordinate alternative level transfers (SNF, ALF, ICF, home health), coordinate equipment and other discharge resources.
   
9. Perform other related duties as may be assigned.

Qualifications:

• Graduate of an accredited school/college of nursing
• Minimum 3 years in a hospital setting with medical/surgical experience with supervisory/preceptor experience (or may have equivalent combination of education and/or experience).
  
• WA State RN Licensure.
  
• Basic Life Support (BLS) for Healthcare Providers required upon hire.

Preferred:

• Discharge planning, case management, quality assurance/quality improvement, clinical documentation and/or utilization management using Intensity Severity Discharge (ISD) preferred.
  
• Certified Case Manager (CCM) & BSN preferred.

Other skills:

• Strong verbal, written and interpersonal communication skills.
• Extensive knowledge of diseases, clinical procedures, treatment, prognosis and hospital functions.
• Skill in the evaluation of quality and appropriateness of care.
  
• 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 ,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).

Benefits: 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.

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

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.