Case Manager Registered Nurse (RN), Case Management
Location:
Richmond , Virginia
Posted:
December 14, 2017
Reference:
00035-36391
We are seeking a Case Manager Registered Nurse (RN) to join the Case Management team at Johnston-Willis Hospital.

The Case Management team at Johnston-Willis Hospital is comprised of skilled and compassionate Registered Nurses (RN) and Social Workers (SW). Our multi-disciplinary team serves as liaison and advocate for and between our patients, their families, the community, and the entire care team.

We cover all areas of the hospital including the Neonatal Intensive Care Unit (NICU), the Emergency Department, Post-Anesthesia Care Unit (PACU), as well as Same-Day Surgery. Using strong critical thinking skills our Case Manager RNs and Social Workers multi-task in a fast-paced and ever-changing environment to develop, implement, and evaluate individualized patient care plans.

Our team collaborates closely with our community partners to provide services to our patients such as home health, hospice, skilled nursing, assisted living, private care, durable medical equipment (DME), such as walkers, oxygen, etc. We also provide resources for those of our patients who are less fortunate and who may not have these resources.
Our team environment supports professional development; several of our Registered Nurses are certified case managers through ANCC and several of our Social Workers are licensed LCSWs.

At Johnston-Willis Hospital, we have been delivering top quality healthcare to Greater Richmond and the Tri-Cities area for more than 100 years, which means our patients can depend on our experience to provide the exceptional care they need. Our 292-bed hospital offers a full range of healthcare services, with specialties in addition to inpatient rehabilitation such as cancer care - through the Thomas Johns Cancer Hospital, our ER which is a state-authorized level III trauma center, and neuroscience, including our first-in-Richmond Gamma Knife Center.

The Case Manager Registered Nurse at Johnston-Willis Hospital:
  1. Reviews health records for appropriateness of application of 2 Midnight Rule for initial review of all Medicare admissions. Performs continued stay reviews of trauma patients for appropriateness based on InterQual® criteria.
  2. Performs admission and concurrent reviews for all payors and maintains legible documentation as directed by the Utilization Management Plan.
  3. Reviews patient notes identifying and addressing any conflict in medical orders or lack of management plan.
  4. Builds a rapport by providing continuity of care with patients and acting as their advocate throughout their hospital stay.
  5. Collaborates between multiple care givers and fosters communication between medical teams and nursing staff.
  6. Identifies and intervenes to coordinate care of trauma patients in relation to appropriateness of level of care, length of stay and resource utilization issues.
  7. Identifies barriers to discharge and contacts relevant personnel to overcome these.
  8. Initiates and monitors referral process of patients post discharge.
  9. Identifies, tracks, and records Avoidable Days [AD], intervening to prevent or decrease as appropriate.
  10. Initiates denial and appeal process in accordance with policy.
  11. Demonstrates awareness of current trends that influence health care practice and assures compliance with professional, regulatory, governmental and organization standards.

Qualifications:
EDUCATION:
  • 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/CERTIFICATIONS:
  • Licensed or eligible for licensure in the State of Virginia as a Registered Nurse (required)
  • Case Management Certification through AACN (preferred)
EXPERIENCE :
  • 5 years of recent clinical experience (required)
  • Commercial Utilization Management and/or Case Management experience (preferred)

A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom

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