Complex Case Manager Care Coordination

Banner Health • Tucson, AZ

1d • Onsite

About The Position

This position provides comprehensive care coordination for assigned patients, with the intensity of services adjusted to patient needs and payer requirements. It is accountable for the clinical quality of care coordination services and identifies and resolves barriers that may hinder effective patient care. The role empowers patients and families to participate in discharge planning and supports safe discharge, continuity of care, and the unique needs of patients of all ages, including those who are physically disabled, mentally ill, chronically ill, or terminally ill.

The role manages a focused caseload of approximately 20–25 medically and socially complex hospital patients, with substantial autonomy in a fast-paced acute-care setting. It serves as an informal leader and resource for peers, supports process improvement, and collaborates with physicians, payers, and interdisciplinary care teams. The position is based at Banner – University Medical Center Tucson in Tucson, Arizona. The schedule is full-time, 40 hours per week, Monday through Friday, consisting of five eight-hour shifts. Listed shift options are 8:00 a.m.–4:30 p.m. or 8:30 a.m.–5:00 p.m.; weekends and holidays are not scheduled. The position reports directly to the Director. Rotating call may be required based on acute-facility needs.

Requirements

• For the RN pathway: knowledge of case management or utilization review normally obtained through completion of a bachelor's degree in case management or health care.
• For the RN pathway: current Registered Nurse (R.N.) license in the state where the employee works.
• For the Social Worker pathway: Master's Degree in Social Work and an LMSW (or equivalent), LCSW, or MSW with the requirement to become licensed within six months of hire; in states that do not recognize an LMSW, a master's degree and Licensed Social Worker status are required.
• For acute-care assignments, Basic Life Support (BLS) certification is required.
• At least two years of clinical experience, with proficiency in the role's required knowledge and skills.
• Demonstrated critical thinking, problem-solving, effective communication, and time-management skills.
• Ability to work effectively in an interdisciplinary team format.
• High-acuity hospital experience is sought for this opening.
• Rotating call may be required based on acute-facility needs.

Nice To Haves

• Certified Case Manager (CCM) certification preferred.
• Additional related education and/or experience preferred.

Responsibilities

• Manage individual patients across the health care continuum to achieve optimal clinical care, financial, operational, and satisfaction outcomes.
• Lead process improvement activities for patient populations.
• Collaboratively develop and manage interdisciplinary patient discharge plans and communicate plans across the continuum of care.
• Maintain knowledge of Medicare, Medicaid, other program benefits, and relevant community resources to assist patients with discharge planning and choices.
• Establish collaborative relationships with physicians, payers, and other health care team members; collect and communicate timely, relevant information to meet payer and regulatory requirements.
• Educate internal health care team members on case management and managed care concepts and facilitate their integration into daily practice.
• Identify and resolve barriers that may hinder effective patient care.
• Support patients and families in participating in discharge planning, including planning for safe discharge and continuity of care.
• May supervise other staff.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level