The Inpatient RN Care Manager is
responsible for coordinating patient care at St. Luke’s Hospital to
support safe, seamless, and timely transitions across the
continuum. This involves utilizing a collaborative process to
assess, plan, implement, and evaluate the options and services
required to meet the health and health related needs of
patients. The Inpatient RN Care Manager is responsible for
progressing patient care, matching patient needs with appropriate
resources and services while optimizing length of stay, and
minimizing avoidable delays in discharge. The Care Management
Department takes a patient-centric team approach to address
high-risk complex patients, improve transitions of care, improve
patient outcomes, and reduce hospital readmissions. The RN
Care Manager will work in active partnership with physicians,
office staff, administration and other health care providers to
develop and implement a well-coordinated plan of care that promotes
the right resources, at the right time and at the right level of
care. The RN Care Manager is responsible for engaging and
supporting patients that are in need of care management
Accountabilities: % of Time
1. Inpatient RN Care Manager
Identifies and prioritizes patients in need
of care management services
Plans with patient, family, caregivers, physicians, and healthcare
team to progress care through the hospitalization and transition to
next level of care
Implements strategies to promote patient engagement, self-care, and
treatment adherence while involving patient in individualized care
Utilizes evidence based guidelines to promote quality care,
decrease variation, and mitigate resource utilization
Identifies and addresses delays in care
Develops and coordinates transition plans for patients transitioned
to home with home health, home infusion, Palliative/Hospice, and
routine sub-acute and skilled post-acute providers; completes all
necessary documentation and necessary handovers
Involves and prepares patient and caregiver for a safe transition
from day one and throughout acute stay, ensuring proper
Monitors cases to determine when patient is ready to transfer to
the next level of care
Maintains clear and concise documentation in patient record to
reflect progress towards discharge including but not limited to
functional limitations, support system needs, psychosocial
characteristics, financial challenges, and other barriers to a safe
and timely transition
Identifies potential or current patient situations which require
referral to other members of the healthcare team
Communicates vertically and laterally to other departments as
needed and keeps leadership informed of any issues
Promotes a culture of two-way communication and collaboration that
informs and engages staff, physicians and post-acute providers
Develops comprehensive knowledge of post-acute care resources and
functions as a liaison to facilitate patient access
Supports compliance with the regulatory landscape
The Inpatient Care Management department
will follow the principles outlined by American Case Management
Association as it pertains the role of the case manager and
professionalism, which are outlined in the scope of services as
A professional case manager emulates the
standards of practice of case managers, their professional
disciplines and the mission, vision and values of their
The case manager:
Aligns practice with the mission, vision
and values of their health care organization
Emulates the standards of practice for both case management and
their professional discipline
Maintains appropriate licensure and certifications
Commits to lifelong learning and strives to improve competence in
all areas of practice
Advances the application of research and evidence-based
Participates in the orientation and training of students and new
Demonstrates commitment, initiative, integrity and flexibility
Regularly evaluates his or her own performance and sets goals for
personal and professional development
Maintains current knowledge of health care economics, trends and
reimbursement methodologies and applies this knowledge to daily
Utilizes data to drive performance improvement
Demonstrates commitment to work partners to
help each other reach mutual goals and learn from each other.
Demonstrates actions and behaviors that consistently promote trust,
respect, a positive attitude and promote team morale.
3. Evaluate and monitor performance
Proactively engage members of the medical staff and nursing staff
to increase understanding of quality initiatives, reimbursement,
risk, and patient satisfaction
Use data to build and evaluate effectiveness interventions
4. Perform other duties as
licensure as a Registered Nurse in the state of Missouri
Three or more
years of experience in a clinical setting, ambulatory or
post-acute, care coordination experience is preferred.
Excellent clinical knowledge and skills, sound critical thinking
and creative problem solving skills required.
Case Management certification preferred.
Must be PC literate with basic knowledge of Windows Microsoft
Office and capable of utilizing electronic medical record.
Comprehensive knowledge of disease conditions and key clinical
protocols and pathways.
Ability to quickly identify and prioritize patient needs to provide
structured and focused support and interventions.
Must be able to work independently and in coordination with various
other persons and professions.
Has knowledge of physician practice operations, hospital
operations, personnel roles, and community resources.
Must have excellent customer relations, communications, and
Employee is required to sit continuously
and walk frequently. Employee must lift/carry a light (1-20
lbs.) medium (21-50 lbs.) and heavy (50 lbs. +) load
occasionally. Employee may be required to lift over 100 lbs.
with assistance. Employee is frequently required to bend,
squat, crawl, kneel, climb, lift waist to overhead. Employee
is occasionally required to reach forward and reach overhead.
Employee may be required to do simple grasping and
Frequently: 34-66%, Continuously: 67-100%)
The most significant of duties are included
but this does not exclude occasional work assignments not mentioned
or developmental duties.
Job Relationships: Interacts regularly with patients,
physicians, families and other internal and external health care
providers and insurance company representatives.
Supervised by: Coordinator, Inpatient Care
Management; Assistant Director, Care Coordination
Takes direction from: Coordinator,
Inpatient Care Management; Manager, Care Management; Assistant
Director, Care Coordination
Faithful to our Episcopal-Presbyterian
heritage and its ministry of healing, St. Luke’s is dedicated to
improving the health of the communities we serve.
Using talents and resources responsibly, we
provide high quality, safe care with compassion, professional
excellence and respect for each other and those we serve.
As an independent healthcare network, we
create healthy communities in the region through our commitment to
high quality, safe and personalized services.
We accept and treat all persons
as being created in the image of God.
We respond with caring to the
needs of others as if they were members of our family.
We honor each person’s rights
and responsibilities in light of the common good.
We set and strive to attain high
standards of performance and continuous improvement.
We use our talents and resources
wisely, with honesty and integrity.
FACES - Friendly - Available -
Caring - Efficient - Safe Communication Standards: Promotes and
provides courteous and effective communication with internal and