Care Connection Case Manager (Grant) - RN

Company: Carilion Clinic
Location: Roanoke
Posted on: May 3, 2025

Job Description:

Provides care management for specific patient populations, utilizing clinical expertise, communication and problem solving skills to achieve optimal clinical and resource outcomes. Promotes cost-effective care by minimizing fragmentation, maximizing coordination and facilitating patient/family movement through the system. Applies protocols when appropriate and facilitates referrals, providing linkages to health and wellness resources across the health care continuum. Promotes interdisciplinary collaboration and teamwork to progress the plan of care. Must possess knowledge of growth and development appropriate to age group served and incorporate plan to meet needs into plan of care.Performs patient/family data collection to assist in identifying individualized care management needs.Works with all Care Coordinators to identify individual care management needs with Care Team to help identify those patients who need close follow up, resources, additional education, and support.Coordinates plan of care and services, directing liaison activities to appropriately integrate the patient into the health care continuum.Facilitates continuity of care using multidisciplinary collaboration and coordination of appropriate health care services and community resources across the care continuum.Maintains effective communications with all disciplines.Coordinates and manages all care transitions with a focus on comprehensive, accurate, and effective communication.Engages and empower patient/ caregiver as an active participant in disease/ condition management.Determines readiness/ willingness to change based on protocols and partners with patient/ caregiver/ care team in identifying goals, plan of action.Identifies and tracks patient/ caregiver capacity for and confidence in self-care.Supports patient/ caregiver in adopting healthy behaviors and promotes lifestyle changes.Advocates for the patient and family throughout the entire episode of care.Participates in Advisory Committee with medical consultant, Educational Consultant, Director, and parents to review processes, improvements, and educational needs for children with special needs.Actively participates in quality improvement projects for our center.Develop and maintain center policies and procedures that adhere to polices for care coordinators related to performance measures and industry standards.Analyze centers data regarding level of care, caseloads, outcomes, etc. to identify trends, establish benchmarks, and along with program development and planning.Implement quality improvement activities to ensure quality based on national case management standards.What We Require:Education: Must have one of the following: RN: Registered Nurse; Bachelors Degree Preferred, BSN preferred. SW: Bachelor's Degree in social work or related degree required.Experience: RN - Recent experience in a physician practice or clinic preferred. SWBS - Social work experience in health care setting preferred.Licensure/Certifications/Registration: RN: Current RN license for the state of VA required, BSN preferred. AHA BLS-HCP required in practices where the Care Coordinator provides direct patient care.SW: Bachelors degree required. LCSW preferred.Other Minimum Qualifications: Must demonstrate knowledge and competency in the following areas: positive interpersonal oral communication skills; effective written communication skills; analytic skills; team player; courteous; ability to resolve complaints/problems; customer-focused philosophy of service delivery; ability; willingness to work as an integral member of a multi-skilled team. Also demonstrate knowledge and competency in: computer literacy; community and system resources; effective interpersonal relations; analysis and research methods.About CarilionThis is Carilion Clinic ...An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.Requisition Number: 152292Employment Status: Regular Part TimeLocation: Carilion Childrens Tanglewood CenterShift: DayShift Details: Monday- Friday 8am-430pm: 24 hours per weekRecruiter: DANA E JOHNSONRecruiter Email: dejohnson@carilionclinic.orgFor more information, contact the HR Service Center at 1-800-599-2537.Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status.Carilion Clinic is a drug-free workplace.by Jobble

Keywords: Carilion Clinic, Danville , Care Connection Case Manager (Grant) - RN, Executive , Roanoke, Virginia