Registered Nurse (RN) Case Manager - PRN

Inova Loudoun Hospital is seeking a Registered Nurse Case Manager 1 to join the Case Management Team on a PRN basis, working 3 night shifts per month. This role focuses on discharge planning and continuity of care for patients in acute and post-acute settings, coordinating services across the healthcare system and acting as a key liaison between patients, families, and interdisciplinary healthcare teams.

Responsibilities

• Provide discharge planning and continuity of care for assigned patients in acute and post-acute settings
• Initiate and facilitate referrals to clinics, home healthcare, hospice, skilled nursing facilities, acute rehab, long-term acute care, transitional care management, and medical equipment suppliers as indicated
• Collaborate with interdisciplinary healthcare teams, patients, and families to assess and coordinate discharge planning needs and facilitate transitions from hospital to community settings
• Document discharge planning information in medical records according to department standards and care management plans
• Collaborate and communicate with internal and external case managers to coordinate services and resolve care barriers
• Act as a key liaison between patients, families, and healthcare team members to manage and coordinate all areas of patient care
• Provide educational resources and referrals to patients and families to address identified social or financial needs
• Advocate for patients to resolve barriers to care progression
• Use utilization management techniques to determine medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities
• Discuss payer criteria and issues on a case-by-case basis with clinical staff and resolve problems with payers as needed
• Apply approved clinical criteria to monitor appropriateness of admissions, continued stays, and post-acute setting placement
• Identify at-risk populations using approved screening tools and established reporting procedures
• Monitor length of stay and ancillary resource use to achieve continuous improvement efficiencies
• Collect and analyze delay and other data for specific performance and outcome indicators
• Assist in collection and reporting of resource and financial indicators including case mix, length of stay, cost per case, excess days, resource utilization, readmission rates, denials, and appeals
• Collect, analyze, and address variances from plans of care and care paths with physicians and healthcare team members
• Use concurrent variance data to drive practice changes and positively impact outcomes
• Document key clinical path variances and outcomes related to discharge planning and chronic disease planning
• Participate in assessment of patients' clinical and psychosocial needs through review of patient information, personal contact with patients and families, and collaboration with interdisciplinary team members
• Communicate routinely with patients, families, healthcare team members, and other appropriate parties regarding care plan status, progress toward treatment goals, concerns, and problem-solving
• Work with multidisciplinary teams to address and resolve system problems impeding diagnostic or treatment progress
• Seek consultation from appropriate disciplines and departments to expedite care and facilitate discharge
• Ensure all critical elements of patients' care plans are communicated to patients, families, and healthcare team members
• Ensure safe care by adhering to policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and accuracy of practice
• Promote professional growth and development by meeting requirements for mandatory and continuing education and skills competency
• Support department-based goals that contribute to organizational success
• Perform other duties as assigned

Schedule

• PRN position requiring 3 night shifts per month

Required Qualifications

• Licensed or eligible for licensure in the Commonwealth of Virginia as a Registered Nurse, or hold an active multi-state Registered Nurse license
• Bachelor's Degree in Nursing or Associate's Degree in Nursing. Candidates with an Associate's Degree must, within 2 years of hire, meet with their nurse leader to identify an accredited school for BSN completion, provide a written plan with anticipated completion date, submit transcripts showing required prerequisites and course timeline, and complete the BSN within 5 years of start date
• One year of case management and/or clinical care experience
• Basic Life Support certification

Preferred Qualifications

• One year of previous inpatient (hospital) case management experience with discharge planning

Benefits

• Medical, dental, and vision coverage
• Robust team member wellness program
• Retirement matching of first 5% of eligible contributions starting on first day
• Tuition and student loan assistance up to $5,250 per year in education assistance and up to $10,000 for student loans
• Mental health support offering 25 mental health coaching or therapy sessions per person per year at no cost for team members, spouses/partners, and children
• Paid time off
• Paid parental leave