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Nurse Case Manager

2 months ago

Oakton, Virginia, United States Inova Health System Full time
Job Title: Registered Nurse Case Manager 1 (RN) - Juniper Clinic

Inova Health System is seeking a skilled Registered Nurse Case Manager 1 (RN) to join our team at the Juniper Clinic. As a key member of our healthcare team, you will play a vital role in providing exceptional patient care and ensuring seamless transitions between healthcare settings.

Job Summary:

The Registered Nurse Case Manager 1 (RN) is responsible for coordinating patient care and services to ensure optimal health outcomes. This includes:

  • Providing discharge planning and continuity of care for assigned patients in acute and post-acute settings
  • Coordinating services and acting as a key liaison between patients, families, and interdisciplinary healthcare team members
  • Using utilization management techniques to determine medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities
  • Ensuring timely regulatory compliance and facilitation of precertification and payer authorization processes when indicated
  • Participating in clinical performance improvement activities and collecting data for specific performance and/or outcome indicators
Responsibilities:

The Registered Nurse Case Manager 1 (RN) will be responsible for:

  • Collecting and analyzing data to identify at-risk populations and referring cases as needed
  • Collaborating with interdisciplinary healthcare team members to ensure effective patient management and care coordination
  • Providing educational resources and referrals to patients and families to address identified needs
  • Acting as an advocate for patients to resolve barriers to care progression
  • Discussing payer criteria and issues on a case-by-case basis with clinical staff and following up to resolve problems with payers as needed
Requirements:

To be successful in this role, you will need:

  • A Bachelor of Science in Nursing degree
  • Minimum of one year Case Management experience and/or Clinical Care experience

Inova Health System offers a dynamic and supportive work environment, competitive compensation, and opportunities for professional growth and development. If you are a motivated and compassionate Registered Nurse with a passion for patient-centered care, we encourage you to apply for this exciting opportunity.