Registered Nurse (RN), Case Manager PRN

Registered Nurse (RN), Clinical Case Manager

Schedule:

Frye Regional Medical Center is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse (RN)joining our team, you're embracing a vital mission dedicated to making communities healthier ^®. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.

More about our team

Reports to: Director of Case Management

1. Departmental Leadership & Strategic Alignment • Assists in developing departmental goals, standards, and objectives aligned with the organization's strategic plan and vision. • Creates and fosters an environment that encourages professional growth. • Integrates evidence-based practices into operations and clinical protocols.

3. Financial & Payer Management • Understands payer issues and anticipates opportunities to reduce expenses and capture revenue from admission through discharge. • Educates physicians and staff on Case Management standards and regulatory requirements (Joint Commission, OSHA, CMS, HCFA, AHCA). • Mentors staff on Utilization Review (UR) standards and Length of Stay (LOS) topics.

5. Interdisciplinary Collaboration • Participates in Interdisciplinary Team Meetings. • Maintains effective communication with all disciplines. • Provides feedback to the healthcare team regarding patient progress and barriers to care. • Coordinates changes to the care plan as needed.

7. Case Management • Acts as gatekeeper for hospital admissions by initiating care in the ED. • Encourages use of reimbursable diagnoses and interfaces with community agencies. • Creates care plans for high-utilization patients and redirects to appropriate hospital services. • Monitors and manages resource use to prevent extended LOS. • Observes ED processes and ensures appropriate level-of-care placement. • Uses EMR and MCG Criteria for utilization management and quality screening. • Identifies and resolves delays in care and discharge planning. • Consults with appropriate departments to expedite care. • Applies conflict resolution skills to ensure timely issue resolution. • Applies utilization acuity criteria and documents findings. • Identifies at-risk populations and follows reporting procedures. • Refers cases to Physician Advisor or secondary reviewer and follows up as needed. • Discusses payer criteria with clinical staff. • Manages discharge planning in coordination with Social Workers. • Initiates referrals for home health, hospice, medical equipment, and facility transfers.

A Registered Nurse (RN)who excels in this role:

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 - with medical plans starting at just $10 per pay period - tailored benefit options for part-time 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.

Frye Regional Medical Center is a 355-bed hospital offering acute care hospital, home to the Frye Regional Brain Center, Heart Center, Cancer Center, Emergency Services, General and Vascular Surgery, Orthopedics, Surgical Weight Loss, Women's Birthing Center and Inpatient Rehabilitation that has been offering exceptional care to the Hickory NC community since 1911. We are proud to be recognized by U.S. News & World Report as a High Performing Hospital.

What we're looking for

Bachelor's degree preferred but not required

30 days of hire.

EEOC Statement