Job Description

Join us as a Registered Nurse (RN) - Care Management LPN position at Physicians Regional Medical Center - CAMPUS

Unit: Care management

Shift: 4x10

Other incentives include: Medical, Vision, Dental, 401k match & more available for eligible employees

The Care Manager LVN/ LPN supports effective utilization management and discharge planning by coordinating patient care activities under the direction of a Registered Nurse or physician. This role involves reviewing medical records for appropriateness and medical necessity, collaborating with interdisciplinary teams, and facilitating safe and timely transitions of care in compliance with federal, state, and accreditation standards.

Essential Functions

• Conducts daily reviews of medical records to assess the appropriateness, medical necessity, and utilization of hospital services, escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee.
• Identifies and documents avoidable hospital days and communicates findings effectively to the UM committee and interdisciplinary teams.
• Coordinates discharge planning activities, including arranging post-hospital placements and collaborating with patients, families, and physicians to ensure continuity of care.
• Maintains professional relationships with community agencies and resources to facilitate referrals and support patient transitions.
• Assists in facilitating interdisciplinary meetings, presenting relevant information, and supporting collaborative care planning.
• Ensures accurate and timely documentation of utilization review, discharge planning activities, and patient interactions in accordance with organizational policies.
• Directs others to comply with the federal mandate for first person reporting. This requirement cannot be delegated to another licensed staff member.
• Participates in the development, implementation, and evaluation of utilization management and discharge planning programs to enhance care delivery and compliance.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• 1-2 years of clinical acute care nursing experience required
• Experience in utilization review, case management, or discharge planning preferred

Knowledge, Skills and Abilities

• Strong understanding of nursing practice, utilization management principles, discharge planning, and transitions of care.
• Knowledge of federal, state, and accreditation standards related to case management and patient care.
• Excellent communication and interpersonal skills to collaborate with interdisciplinary teams and community resources.
• Organizational and time management skills to prioritize tasks and meet deadlines in a dynamic environment.
• Proficiency in electronic medical records (EMR) systems and documentation processes.
• Ability to assess complex situations, identify solutions, and implement effective care plans.

Licenses and Certifications

• LPN - Licensed Practical Nurse - State Licensure Licensure in state of employment required or
• LVN - Licensed Vocational Nurse Licensure in state of employment required
• BLS - Basic Life Support preferred