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Registered Nurse (RN) - Hospital Care Manager, Emergency Department, FT, Nights

Company: Prisma Health
Location: Greenville
Posted on: November 21, 2022

Job Description:

Inspire health. Serve with compassion. Be the difference.

Job Summary

The Hospital Care Manager (HCM) is an integral care team partner that focuses on patient engagement and activation, has primary accountability for patients' care transition out of the acute care setting and positively impacts longitudinal care plan alignment. In collaboration with physicians, leads the multidisciplinary team including clinical staff and payors to ensure efficient delivery of quality, cost-effective care. The HCM leads the team for each patient individually with the goal to maximize autonomy where possible.


Partners with the attending providers throughout hospitalization to promote effective and efficient utilization of clinical resources, ensuring quality, cost effective care. Anticipate next steps and facilitate communication to maximize care efficiencies for the patient and family. -10%
Identifies social determinants of health that increase the patient's risk for negative outcomes. Ensures clear documentation for the interdisciplinary care team and coordinates post-acute plans with the ambulatory care management team as appropriate. Facilitates patient access to resources and relevant services. 10%
Addresses and resolves system problems impeding diagnostic or treatment progress. Proactively identifies, resolves and documents delays and obstacles on the patient's behalf. Drives change by identifying areas where performance improvement is needed. 10%
Navigates value based care with expertise and ensures longitudinal plan is patient focused and aligns with patient and caregiver goals. 10%
On the basis of preliminary risk screening, assesses patients' and family's psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope. 10%
Maintains expert level knowledge of body systems and expected clinical outcomes for patient disease process. Maintains current knowledge of changes in state and federal regulatory requirements related to the provision of care management services in an acute care setting. - Maintains care management knowledge to provide services in accordance with standards of practice as established by department and management. 10%
Ensures medical necessity, appropriate level of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan. 10%
Navigates the team through complex compliance, regulatory and insurance requirements. Coordinates with third party payors on a regular basis. 10%
Serves as a resource for patients and families with regard to their rights and responsibilities, when payment of care is denied or when care is no longer medically necessary. Includes, but not limited to, delivery of the regulatory documents as provided by CMS. 10%
Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system. 10%

Minimum Qualifications

Education - Bachelors degree in nursing
Experience - Three (3) years acute care nursing experience. One (1) year acute care/ case management experience preferred. - - - -

Required Licensure

Licensed to practice as a Registered Nurse in South Carolina

Other Required Skills/Experience

Accredited Case Manager (ACM) or Certified Case Manager (CCM) is preferred.

Knowledge of Medical Necessity Criteria is preferred.

Grandfather Status

Employees in this title prior to 10/24/2021 are grandfathered into the title and are only required to have an AD N or Nursing Diploma.

Work Shift

Night (United States of America)


Greenville Memorial Med Campus


1001 Corporate Services - Upstate


10207503 Social Work

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health. - - - - - - - -

---------------------A place where nurses thrive
At Prisma Health, each of our nurses brings their own unique characteristics to their jobs. But what binds us together is our common commitment to Inspire health. Serve with compassion. Be the difference.---------------

RN sign-on bonus currently available
Now is the perfect time to join Prisma Health if you are an experienced RN with a minimum of 1-year acute care experience and licensed in South Carolina! We offer up to a $30,000 sign-on bonus for eligible full-time positions and $10,000 for part-time positions (minimum of 20 hours per week). Prisma Health requires a one-year commitment (we're confident you're going to love working here). We also offer relocation assistance!

Our team
Our team is comprised of nearly 29,000 people helping us change thousands of lives for the better every day.

A strong legacy of care

As South Carolina's largest private, non-profit healthcare system, and second-largest private company, we are here to create a better state of health for South Carolinians. Prisma Health is inspired to help people live their healthiest lives. As the most comprehensive integrated healthcare system in South Carolina, we're on a journey to transform the healthcare experience for our patients and their families.

That's why our team members are dedicated to living our purpose: -Inspire health. Serve with compassion. Be the difference.

Keywords: Prisma Health, Greenville , Registered Nurse (RN) - Hospital Care Manager, Emergency Department, FT, Nights, Executive , Greenville, South Carolina

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