Free Utilization Review Training Jobs in Virginia

Employment Status:Full timeShift:Weekends Only (United States of America)Facility:1906 Belleview Ave SE - RoanokeRequisition Number:R161665 RN Case Manager - Weekends (Open) How You'll Help Transform Healthcare:The RN Case Manager provides case management for assigned patient populations. Utilizes clinical expertise, communication and problem solving skills to achieve optimal clinical and resource outcomes. Promotes cost-effective care by minimizing fragmentation, maximizing coordination, and facilitating patient/family movement through the health care organization. performs patient needs assessments upon admission and at regular intervals; facilitating referrals and providing linkages to health, wellness, and post-acute care resources across the health care continuum.

Sign on bonus and relocation assistance available!

The RN Case Manager

• Provides care management for assigned patient populations, utilizing clinical expertise, communication, and problem-solving skills to achieve optimal clinical and resource outcomes.
• Performs patient needs assessments upon admission and at regular intervals to support care planning, discharge planning, and transitions across the continuum of care.
• Facilitates safe and effective transitions of care, including coordination of post-acute services such as home health, hospice, and durable medical equipment.
• Promotes interdisciplinary collaboration with physicians, nursing, social work, utilization review, and other care team members to ensure alignment of the plan of care and discharge plan.
• Ensures appropriate utilization of resources, length of stay management, and compliance with regulatory and payer requirements.
• Collaborates with Utilization Review to ensure accurate patient status and medical necessity using tools such as InterQual.
• Coordinates with patients and families to ensure understanding of discharge plans, including financial implications and available resources.
• Ensures documentation accurately reflects patient condition, comorbidities, treatment, and interventions in accordance with regulatory and organizational standards.
• Coordinates referrals and authorizations for medications, services, and post-acute care needs to prevent discharge delays.
• Facilitates communication and coordination for patient transfers, including acute-to-acute transitions and transitions involving correctional facilities.
• Identifies and addresses barriers to discharge and implements appropriate interventions.
• Participates in interdisciplinary team meetings and contributes to care progression and discharge planning discussions.
• Maintains effective communication with all disciplines to support timely and appropriate patient care transitions.
• Engages in performance improvement initiatives and utilizes predictive analytics tools to support patient outcomes and reduce readmissions.
• Collects and analyzes patient care and utilization data to support quality and fiscal outcomes.
• Advocates for patients and families throughout the episode of care.

What We Require:

Education: Bachelor's degree required. 5 years Case Management experience in a hospital setting may be considered in lieu of a Bachelor's degree

Experience: 3 years of recent experience in a clinical health care setting with responsibilities reflecting direct management of patient care including planning, coordination, and delivery of needed services such as education, psychosocial support, discharge planning and utilization management. Supervisory or leadership experience is preferred

Licensure, Certification, and/or Registration: Current Registered Nurse License in the State of Virginia required. Life Support: None required.

Other Minimum Qualifications: Decisions have a significant impact on quality of services and care, fiscal results, attainment of goals and development and retention of employees.

This job description is intended to be a representative summary of the major responsibilities and accountabilities performed by incumbents in this role. Incumbents may be required to perform job-related tasks other than those specifically presented in this description.

Compensation Range:

$76,689.60 - $115,044.80

Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan.

Recruiter:

DANA JOHNSON

Recruiter Email:

dejohnson@carilionclinic.org

For more information, contact the HR Service Center at 1-800-599-2537.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.

For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies

Benefits, Pay and Well-beingat Carilion Clinic

Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That's why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life - at work and when you're away.

When you make your tomorrow with us, we'll enhance your potential to realize the best in yourself.Below are benefits available to you when you join Carilion:

• Comprehensive Medical, Dental, & Vision Benefits
• Employer Funded Pension Plan, vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• Onsite fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app, Personify Health
• Discounts on childcare
• Continued education and training