RN Care Manager– St. Rita's Hospital

RN Care Manager – St. Rita's Hospital at Mercy Health

Everyone who works with Mercy Health is united under one purpose: to help our patients be well in mind, body and spirit. This drive, along with our history of faith, is a powerful combination. It gives us a shared calling to work toward every day. Join our exceptional team and help us continue to provide the highest quality of health care possible to our communities.

The RN Care Manager is responsible for providing coordination of care for patients to support safe, seamless, timely transitions across the continuum. This role utilizes a collaborative process, the RN Care Manager identifies (using quantitative and qualitative methods), assesses, plans, implements and evaluates the options and services required to meet an individual’s health and health related needs, including social‑determinants that affect one’s overall wellbeing.

The RN Care Manager is responsible for screening, identification, and assessment of individuals in need of active Case Management services and promotes the right resources, at the right time and at the right place.

• Identifies and prioritizes patients in need of care management services, using a holistic approach inclusive of biopsychosocial, functional, cultural, spiritual, and financial factors. Plans with the patient, caregivers and members of the healthcare team to maximize health care responses, quality and cost‑effective outcomes. Monitors and revises the plan as indicated when patient condition changes.
• Completes all necessary documentation. Maintains, clear, concise, and timely documentation in the patient record to reflect the needs of the patients. Handovers are expected to be utilized at points of level of care change, staff change, as well as care transitions.
• Documentation will reflect plan of care to address post hospital care needs and resources and evidence of patient, family or caregiver involvement in planning. Ensuring patient’s and caregiver’s treatment goals and preferences are incorporated into the transition of care planning and communicated to the multidisciplinary team.
• Follow standardized practices and process related to Advance Care Planning, Length of Stay management and readmission prevention.
• Supports denial prevention related to medical necessity through addressing / removing barriers to progression of care and participating in Interdisciplinary Discharge Rounds.
• Supports and promotes assertive, proactive care for patients, assisting in removing barriers related to achieving timely testing and treatment. Ensures resources are utilized appropriately and offering alternatives to acute care to the care team.
• Works in collaboration with revenue cycle partners to help remove barriers to ensure patients are in the appropriate classification as guided by the physician.
• Works in conjunction with patient access to ensure all regulatory letters are delivered to the patient in a timely manner.
• Participates in department clinical outcome projects as well as process improvement initiatives within the care management department.
• Works collaboratively with peers to achieve facility and department goals and daily work as evidenced by appropriate and timely communication which is respectful and clear.
• Shares responsibilities, promoting team based approach to accomplish work.
• Strong collaborative partnerships with other members of the care team.
• Supports and follows compliance rules and regulation as mandated by CMS and Conditions of Participation for discharge planning and utilization management. Addresses opportunities or potential concerns with leadership.

• BLS Basic Life Support – American Heart Association (required)
• RN License in the state in which they are working or covered by compact (required)
• Accredited Case Manager Certification (ACM) from American Case Management Association or Certified Case Manager (CCM) from Commission for Case Manager Certification or American Nurses Credentialing Center (ANCC) Nursing Case Management board certification (preferred)

Bachelor of Science in Nursing (preferred for BSMH,…