NURSE CASE MANAGERS - 208415
Regular
Pay Range
$37.24 - $54.07
The Unit Clinical Care Coordinator serves as the primary liaison among emergency services, surgical services, nursing, finance, physicians, utilization review, and medical records to ensure appropriate bed assignments, patient care needs are met, and treatment plans are executed at the correct level of care. This role requires exceptional organizational skills to manage multiple tasks simultaneously and the ability to respond effectively in crisis situations, quickly assimilating information to make sound decisions and recognizing circumstances that demand immediate intervention. The coordinator maintains up-to-date knowledge of healthcare economics, trends, and reimbursement methodologies, applying this expertise to daily practice while continuing professional development to deliver care tailored to each patient. Additionally, the Unit Clinical Care Coordinator oversees patient progression and length of stay for the unit’s patients through collaboration and partnership with all members of the healthcare team.
Responsibilities and Duties
Partners with PLC and other care coordination roles to facilitate patient progression of care.
Provides PLC with timely visibility to potential unit transfers and discharges.
Ensures Care Logistics software accurately reflects unit and patient status, including transfers, discharges, and patient location.
Reviews physician admission orders and validates status and level of care; manages observation hours and inpatient target LOS.
Evaluates discharge needs upon admission and ensures a complete discharge plan; refers complex cases to appropriate roles.
Collaborates with unit staff and support teams to progress patient care toward discharge and expedite unit flow for admissions, transfers, and discharges.
Adjusts unit staffing needs based on census and callouts in coordination with Care Management leadership.
Completes required care management functions and documentation, including discharge planning assessments and coordination of simple discharges such as home health, DME, or dialysis.
Oversees completion of pre-procedural requirements and communicates readiness or barriers to the Order Organizer.
Identifies opportunities to transition testing to outpatient settings and escalates as appropriate.
Maintains daily communication with physicians through SNAP huddles or Epic to address progression and discharge barriers.
Manages and updates Care Advance in real time.
Identifies patients at risk for readmission and communicates findings to the care team; verifies completion of readmission assessments.
Leads SNAP huddles to anticipate and resolve barriers to progression or discharge; escalates unresolved issues to unit leadership.
Reviews expected discharge dates, target LOS, and working DRG daily; collaborates with CDI team for DRG updates and documentation queries.
Assigns and resolves discharge needs and barriers with nursing and care team roles; initiates interventions as needed.
Monitors patients in observation or outpatient status and updates status appropriately.
Coordinates sequencing of care and interventions with physicians and nurses; ensures appropriate order sets and protocols are initiated.
Collaborates with PLC, ED, surgical teams, providers, and other disciplines on patient progression and care coordination.
Works with PLC Program Assistant for transportation and other care arrangements.
Communicates discharge goals and plans with patients and families in collaboration with providers and care team; addresses concerns and arranges family meetings as needed.
Updates patient status and planned discharge times in Care Logistics software and EMR.
Collaborates with Utilization Review nurses on status changes and delivers regulatory letters when required.
Ensures payer and status requirements align with clinical progression in collaboration with UR nurses.
Serves as consultant and educator for medical staff regarding patient status, placement, payer requirements, and resource utilization.
Proactively identifies and removes barriers to patient flow at the unit and system level.
Meets deadlines and exceeds facility and unit metrics through adherence to policies and standard operating procedures.
Education
Bachelor's Nursing (BSN) is required. Will consider ASN RN who completes a 3 year education agreement.
Masters Nursing (MSN) is preferred.
Graduate of an accredited school of nursing is required.
Experience
Minimum five years of professional practice experience in an acute care setting is preferred.
Prior Case Management or Utilization Management is preferred.
Clinical experience in acute care hospital setting is strongly preferred.
Certification & Licensure
Licensed as a Registered Nurse in the State of Virginia is required. Registered Nurse must hold either:
- A current multistate (compact) RN license issued by the nurse’s state of residency (RNs have 60 days after relocating to a new state to apply for a multistate (compact) RN license in their new state of residency); or
- A current single‑state RN license issued by Virginia and/or West Virginia, as applicable based on the location(s) where the Registered Nurse will be providing services.
BLS Certification (Basic Life Support) American Heart 'Healthcare Provider' (HCP) AHA approved is required. New hires must have American Heart Association (AHA) appropriate certification prior to completion of orientation.
Certified Case Manager (CCM) or Accredited Case Manager (ACM) certification is required within (4) years of hire.
Qualifications
Excellent written/verbal communication and interpersonal skills with all levels of internal and external customers, critical thinking skills, creative problem solving, proficient organization, and planning.
Must be self- directed and can tolerate frequent interruptions and a demanding workload
Knowledge of funding, resources, services, clinical standards, and outcomes is preferred.
Demonstrated ability to be creative, innovative, and flexible in responding to rapidly changing needs and priorities
At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include:
- A Zero-Deductible Health Plan
- Dental and vision insurance
- Generous Paid Time Off
- Tuition Assistance
- Retirement Savings Match
- A Robust Employee Assistance Program to help with many aspects of emotional wellbeing
- Membership to Healthy U: An Incentive-Based Wellness Program
Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more.
To see the full scale of what we offer, visit valleyhealthbenefits.com .
