The Inova Center for Personalized Health (ICPH) is seeking an experienced RN
Case Manager to join our growing team. This is a fully remote position after the
completion of onsite training at ICPH.
Inova is consistently ranked a national healthcare leader in safety, quality and
patient experience. We are also proud to be consistently recognized as a top
employer in both the D.C. metro area and the nation.
The RN Case Manager 1 provides discharge planning and continuity of care for
assigned patients in acute and post-acute settings. Provides coordination of
services and acts as key liaison between patients, families and
interdisciplinary healthcare members. Uses utilization management techniques to
determine the medical necessity, appropriateness and efficiency of the use of
healthcare services, procedures and facilities. Responsible for the timely
regulatory compliance and facilitation of precertification and payer
authorization processes when indicated. Actively participates in clinical
performance improvement activities.
Featured Benefits:
* Committed to Team Member Health: offering medical, dental and vision
coverage, and a robust team member wellness program.
* Retirement: Inova matches the first 5% of eligible contributions – starting
on your first day.
* Tuition and Student Loan Assistance: offering up to $5,250 per year in
education assistance and up to $10,000 for student loans.
* Mental Health Support: offering all Inova team members, their
spouses/partners, and their children 25 mental health coaching or therapy
sessions, per person, per year, at no cost.
* Work/Life Balance: offering paid time off, paid parental leave
Registered Nurse (RN) Case Manager I Job Responsibilities:
* Collects delay and other data for specific performance and/or outcome
indicators. Assists in the collection and reporting of resource and financial
indicators including acute and post-acute case mix, LOS, cost per case,
excess days, resource utilization, readmission rates, denials and appeals.
Collects, analyzes and addresses variances from plans of care and care paths
with physicians and/or other members of the healthcare team. Uses concurrent
variance data to drive practice changes and positively impact outcomes.
Documents key clinical path variances and outcomes which relate to areas of
direct responsibility (e.g. discharge planning, chronic disease planning).
* Uses pathway data in collaboration with other disciplines to ensure effective
patient management concurrently. Ensures safe care to patients by adhering to
policies, procedures and standards within budgetary specifications including
time management, supply management, productivity and accuracy of practice.
Promotes individual professional growth and development by meeting
requirements for mandatory/continuing education and skills competency.
Supports department based goals which contribute to the success of the
organization.
* Provides discharge planning and continuity of care for assigned patients in
the acute and post-acute setting. Initiates and facilitates referrals to
clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical
equipment and supplies as indicated. Collaborates with the interdisciplinary
healthcare team, patients and families in the assessment and coordination of
discharge planning needs, delivery of post-discharge planning needs, delivery
of post-discharge services and transition of patients from hospitals to the
discharge setting as well as ongoing care in the community. Documents
relevant discharge planning information in medical records according to
department standards and/or care management plans.
* Collaborates/communicates with internal and external case managers.
Understands pre-acute and post-acute resources. Provides coordination of
services and acts as a key Liaison between patients, families and the
interdisciplinary healthcare team members. Work closely with members of
patients' healthcare teams to manage and coordinate all areas of patients'
care. Works holistically to ensure that healthcare plans and discharge plans
meet the physical, social and emotional needs of patients.
* Provides educational resources and/or referrals to patients and patients'
families to address identified needs such as social or financial. Acts as an
advocate for patients to resolve barriers to care progression. Uses
utilization management techniques to determine the medical necessity,
appropriateness and efficiency of the use of healthcare services, procedures
and facilities.
* Discusses payer criteria and issues on a case by case basis with clinical
staff and follows-up to resolve problems with payers as needed. Applies
approved clinical criteria to monitor appropriateness of admissions,
continued stays or post-acute setting appropriateness and documents findings
based on department standards.
* Identifies at risk populations by using approved screening tools and
following established reporting procedures. Monitors LOS and ancillary
resource use, depending on inpatient stay or outpatient program criteria, on
an ongoing basis and takes actions to achieve continuous improvement
efficiencies in both areas. Refers cases and issues appropriately to resolve
barriers to care progression.
* Participates in the assessment of patients' clinical and psychosocial needs
through review of patient information, personal contact with
patients/families and interdisciplinary healthcare team members. Communicates
routinely with patients, families, interdisciplinary healthcare team members
and other appropriate parties with regard to the status of patients' care
plans and progress toward treatment goals, identification of concerns and/or
problems, problem solving and assisting with conflict resolution when
necessary. Works with the multidisciplinary team to address/resolve system
problems impeding diagnostic or treatment progress. Seeks consultation from
appropriate disciplines/departments as required to expedite care and
facilitate discharge. Ensures that all elements critical to patients' care
plans have been communicated to the patients/families and members of the
healthcare team.
* Performs other duties as assigned.
Minimum Qualifications:
* Certification: Basic Life Support (American Heart Association)
* Licensure: Licensed or eligible for licensure in the Commonwealth of Virginia
as a Registered Nurse or an active multi-state Registered Nurse license
* Experience: 1 year of case management and/or clinical care experience
* Education: Bachelor's Degree Nursing or Associate's Degree. If RN has an
Associate's Degree, within 2 years of date of hire, they must meet with their
nurse leader and conduct the following: 1.) Identify which accredited school
they plan to attend 2.) Provide a written plan with anticipated BSN
completion date 3.) Submit a review of transcripts from the school indicating
the required pre-requisites and timeline for taking the courses 4.) Complete
BSN within 5 years of start date.
We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Every
day, our 26,000+ team members provide world-class healthcare to the communities
we serve. Our people are the reason we're a national leader in healthcare
safety, quality and patient experience. And from best-in-class facilities to
professional development opportunities, we support them at every step. At Inova,
we're constantly striving to be ever better — to shape a more compassionate
future for healthcare.
Inova Health System is an Equal Opportunity employer. All qualified applicants
will receive consideration for employment without regard to age, color,
disability, gender identity or expression, marital status, national or ethnic
origin, political affiliation, pregnancy (including childbirth,
pregnancy-related conditions and lactation), race, religion, sex, sexual
orientation, veteran status, genetic information, or any other characteristics
protected by law.