Case Management Program Manager; Registered Nurse OR Social Worker

Case Management Program Manager (Registered Nurse OR Social Worker)

Inova Mount Vernon Hospital is looking for a dedicated Experienced Case Management Program Manager to join the Case Management Team. This role is Full‑Time, Day shift:
Monday - Friday 8:30 am – 5:00 pm with occasional weekends and holiday rotation.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are proud to be consistently recognized as a top employer in the D.C. metro area and nationwide. Inova Mount Vernon Hospital is a 237‑bed hospital offering patients convenience and state‑of‑the‑art care in a community environment.

• 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, and flexible work schedules.

• Serves as resource for discharge planners (DCP) and the multi‑disciplinary team through guidance, training, consultation, participating in Multi‑Disciplinary Rounds (MDRs), and managing assigned patients.
• Ensures continuity of care by reviewing patient assessments, ensuring appropriate referrals for Social Determinants of Health (SDOH) patient/family needs, and identifying at‑risk populations using approved screening tools.
• Initiates and facilitates referrals to specialists, clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated.
• Communicates routinely with patients, families, interdisciplinary healthcare team members and other appropriate parties regarding the status of patients' care plans, progress toward treatment goals, identification of concerns/problems, problem‑solving and conflict resolution.
• Seeks consultation from appropriate disciplines/departments to expedite care and facilitate discharge.
• Communicates with payers or required parties to ensure reimbursement certification, discusses payer criteria with the Discharge Planner and follows up to resolve problems with payers.
• Works closely with Discharge Planners (DCP) and patients' healthcare teams to manage and coordinate all areas of care and collaborates with interdisciplinary care teams and families in discharge planning.
• Ensures safe care to patients by adhering to policies, procedures and standards, within budgetary specifications including time/supply management, productivity and accuracy of practice.
• Collects and reports resource and financial indicators including clinical metrics case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals.
• Serves on agency committees, work groups, and other bodies.
• Responsible for quality assurance in the unit’s service delivery including clinical care and documentation, analyzing variances from plans of care and care paths with physicians and/or other team members, collecting delay and other data, and quality metrics for performance indicators.
• Performs additional duties as assigned.

• Education:
  
  Requires a Bachelor’s Degree in Nursing or Master’s Degree in Social Work.
• Experience:
  
  Requires a minimum of five (5) years acute care case management experience in an acute healthcare environment. Demonstrated understanding of DCP for specific disease states and of the impact of SDOH on health.
• License:
  Must be licensed in the Commonwealth of Virginia to practice as a Registered Nurse (RN) or licensed as a Licensed Clinical Social Worker (LCSW) in Virginia and eligible to practice in the Commonwealth of Virginia as a Social Worker.
• Certification:
  Basic Life Support (BLS) for Healthcare Provider certification from the American Heart Association required upon start. Must have one of the following:
  …