NorthShore

RN Care Manager - Care Coordination

NorthShore$84K — $130K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Current professional Nursing Licensure in the state of IL required
  • Bachelor's degree required; preferred in Nursing from an NLN accredited school
  • Clinical certification such as case management beneficial
  • Minimum of 2 years clinical nursing experience required
  • Experience in Utilization Management, Managed Care, or chronic disease management preferred
  • Familiarity with EMR platforms preferred
  • Knowledge of InterQual or MCG criteria preferred

Responsibilities

  • Facilitate payor authorization processes ensuring accurate patient type assignment
  • Manage collaborative patient care across the continuum, removing barriers to timely care
  • Collaborate with the CDI team to ensure accurate documentation of severity of illness
  • Maintain active communication with physicians and multi-disciplinary teams for patient progression
  • Address and resolve system problems hindering diagnostic or treatment progress
  • Consult with appropriate disciplines to expedite care and facilitate discharge
  • Monitor patient progress to ensure care plans are patient-focused and efficient

Benefits

  • Premium pay for eligible employees
  • Career Pathways for professional growth
  • Various Medical, Dental, and Vision options
  • Tuition Reimbursement
  • Free Parking at designated locations
  • Wellness Program Savings Plan
  • Health Savings Account Options
  • Retirement Options with Company Match
  • Paid Time Off
  • Community Involvement Opportunities
Full Job Description
Hourly Pay Range:
$40.45 - $62.70 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:
  • Position: RN Care Manager
  • Location: Arlington Heights, IL
  • Full Time: 36 hours/week
  • Hours: Monday-Friday, 8:00a-4:30p
  • Rotating every 3rd weekend, with 1 summer and 1 winter holiday coverage required


What you will need:
  • License: Current professional Nursing Licensure in the state of IL required
  • Education: Bachelor's degree required. Bachelor's degree in Nursing from a NLN accredited school of nursing is preferred.
  • Certification: Clinical certification, such as case management certification, is beneficial. Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross).
  • Experience: Minimum of 2 years clinical nursing experience required; Previous experience in Utilization Management, Managed Care or chronic disease management highly preferred. Experience with Electronic Medical Record (EMR) platform preferred. Knowledge of InterQual or MCG criteria is preferred.

What you will do:
  • Facilitates payor authorization processes and ensures that the patient type assigned is accurate.
  • Facilitates the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement.
  • Works with the CDI team to ensure that documentation accurately reflects severity of illness and intensity of service.
  • Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient progression.
  • Addresses/resolves system problems impeding diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge so that length of stay is optimized.
  • Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
  • Monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective.

Benefits (for full and part-time positions):
  • Premium pay for eligible employees
  • Career Pathways to Promote Professional Growth and Development
  • Various Medical, Dental, and Vision options
  • Tuition Reimbursement
  • Free Parking at designated locations
  • Wellness Program Savings Plan
  • Health Savings Account Options
  • Retirement Options with Company Match
  • Paid Time Off
  • Community Involvement Opportunities


About NorthShore

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