RN Case Manager

RN Case Manager

Schedule: Monday-Friday usually 8-hour shifts

Current call matrix is rotating call.

Job Location Type: In Person

Your experience matters

Sovah Health - Danville is part of Lifepoint Health, a nationally recognized healthcare network committed to making communities healthier®. We prioritize your well-being so you can deliver exceptional care to every patient.

As a Registered Nurse, you'll join a dedicated team where your skills, compassion, and clinical expertise make a direct and meaningful impact every day.

More about our team

Our Case Management team focuses on serving the adult population in our community, maintaining a patient-to-staff ratio that is below the national average. Our collaborative approach to safe, effective discharge planning includes close coordination between a Utilization Review RN, Case Manager RN, and Social Worker--ensuring each patient receives comprehensive, personalized support throughout their care journey.

How you'll contribute

A RN Case Manager who excels in this role:

• Completes documentation per workflow timeline and content requirements including completion of the Individual Plan of Care (IPoC) per CMS guidelines.

• Schedules family conferences and/or communicates with caregiver following each team conference and more often as needed to keep patient and designated caregiver informed of progress and provides appropriate information related to goal achievement, course of rehabilitation stay, and plans for discharge.

• Coordinates weekly patient care team conferences to facilitate development, monitoring and refinement of treatment plan to achieve identified patient goals and outcomes.

• Reviews the patient's assigned CMG and helps the team identify any potential missed comorbid conditions that are actively being treated during the patient's stay. Communicates any findings to the HIM team.

• Assists with concurrent and retrospective utilization review activities including denials and appeals. Works with physicians to conduct peer review with payer medical director when indicated.

• Ensures clinical updates are provided to all insurance payers when due and all payer communications are documented in Meditech.

• Coordinates discharge planning needs including but not limited to; home health services, physician follow up care, durable medical equipment, medical supplies, healthcare services, outpatient therapy, dialysis, skilled nursing care, assisted living care, hospice care, private duty care, etc. Responsible for coordinating all patient care needs prior to discharge ensuring a safe thorough discharge plan. Ensures patient choice is offered and documented as per CMS' Conditions of Participation for Discharge Planning.

• Identifies trends that impact the quality, cost effectiveness, patient experience and delivery of care services and brings to departmental leadership meetings for discussion and action.

• Performs intake assessment on patient within 24 to 72 hours of admission, preferably within 48 hours.

• Performs follow-up assessments per Case Management Plan and/or hospital policy.

Why join us

We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:

Comprehensive Benefits: Multiple levels of medical, dental and vision coverage, tailored benefit options for part-time and PRN employees, and more.

Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.

Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.

Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).

Professional Development: Ongoing learning and career advancement opportunities.

More about Sovah Danville

Sovah Health - Danville is a 250-bed academic community hospital and the region's only designated Chest Pain Center and Certified Advanced Primary Stroke Center. Serving the community for more than 120 years, the hospital offers comprehensive surgical services, emergency care, home health & hospice, cardiac services, oncology services, and more.

Sovah Health - Danville is accredited by:

• American College of Cardiology (Chest Pain Center & Heart Failure)
• American College of Surgeons' Commission on Cancer
• Member of the Duke Heart Network and Duke Telestroke Network

What we're looking for 

The right candidate will coordinate management of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Serves as a patient advocate through resource utilization, discharge planning and addressing the holistic needs of the patient.

 

Applicants should have a current VA RN license or compact state

• Bachelors degree preferred but not required

Additional requirements include:

• Experience in acute care hospital, preferred

EEOC Statement

Sovah Health - Danville is an Equal Opportunity Employer. Sovah Health - Danville is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.