HCA, Hospital Corporation of America Case Manager-PRN in Richmond, Virginia

We are seeking a Case Manager Registered Nurse (RN) to join the Case Management team at Chippenham Hospital.

The Case Management team at Chippenham Hospital is comprised of skilled and compassionate Registered Nurses (RN) and Social Workers (SW). Our multi-disciplinary team serves as liaison and advocate for and between our patients, their families, the community, and the entire care team.

We cover all areas of the hospital including the Neonatal Intensive Care Unit (NICU), the Emergency Department, Post-Anesthesia Care Unit (PACU), as well as Same-Day Surgery. Using strong critical thinking skills our Case Manager RNs and Social Workers multi-task in a fast-paced and ever-changing environment to develop, implement, and evaluate individualized patient care plans.

Our team collaborates closely with our community partners to provide services to our patients such as home health, hospice, skilled nursing, assisted living, private care, durable medical equipment (DME), such as walkers, oxygen, etc. We also provide resources for those of our patients who are less fortunate and who may not have these resources.

Our team environment supports professional development; several of our Registered Nurses are certified case managers through ANCC and several of our Social Workers are licensed LCSWs.

As one of the largest facilities in HCA which is the nation’s largest hospital system Chippenham Hospital provides the full scope of healthcare services. With 466 beds, we specialize in heart care at the Levinson Heart Hospital and emotional and mental health services through the Tucker Pavilion. Our Emergency Room (ER) is also a state-authorized Level II trauma center and we offer Central Virginia’s only Pediatric ER staffed 24/7 by pediatric-trained ER nurse and physician specialists.

The Case Manager Registered Nurse at Chippenham Hospital: 1. Reviews health records for appropriateness of application of 2 Midnight Rule for initial review of all Medicare admissions. Performs continued stay reviews of trauma patients for appropriateness based on InterQual® criteria.

  1. Performs admission and concurrent reviews for all payors and maintains legible documentation as directed by the Utilization Management Plan.

  2. Reviews patient notes identifying and addressing any conflict in medical orders or lack of management plan.

  3. Builds a rapport by providing continuity of care with patients and acting as their advocate throughout their hospital stay.

  4. Collaborates between multiple care givers and fosters communication between medical teams and nursing staff.

  5. Identifies and intervenes to coordinate care of trauma patients in relation to appropriateness of level of care, length of stay and resource utilization issues.

  6. Identifies barriers to discharge and contacts relevant personnel to overcome these.

  7. Initiates and monitors referral process of patients post discharge.

  8. Identifies, tracks, and records Avoidable Days [AD], intervening to prevent or decrease as appropriate.

    1. Initiates denial and appeal process in accordance with policy.

    2. Demonstrates awareness of current trends that influence health care practice and assures compliance with professional, regulatory, governmental and organization standards.


    • Diploma or Associates Degree from a professional nursing program (required)

    • BSN or current enrollment in a BSN program at an accredited school of Nursing (preferred) LICENSURE/CERTIFICATIONS:

    • Licensed or eligible for licensure in the State of Virginia as a Registered Nurse (required)

    • Case Management Certification through AACN (preferred) EXPERIENCE :

    • 5 years of recent clinical experience (required)

    • Commercial Utilization Management and/or Case Management experience (preferred)

Job: *Case Management

Title: Case Manager-PRN

Location: Virginia-Richmond-Chippenham Hospital

Requisition ID: 00035-40647