Inpatient Care Manager NEX

Advocate Health•Charlotte, NC

5d•$38 - $57

About The Position

The Inpatient Care Manager conducts patient assessments, develops care plans, and initiates interventions within appropriate timeframes. The role works with patients, families, and the healthcare team to support care decisions, discharge planning, and transitions while considering patient needs, choices, and satisfaction. It uses patient and family strengths in problem-solving and involves them in decisions throughout the hospital stay. The position coordinates continuity of care and discharge planning in compliance with regulatory standards, makes referrals, documents discharge planning and utilization review activities, and conducts concurrent and retrospective reviews. It collaborates with Social Work, medical staff, hospital departments, ancillary services, and community organizations to coordinate care, resolve barriers, and support safe, timely transitions. The role also supports utilization management, including payer updates, denial activity, avoidable-delay management, and delivery of applicable CMS notices. The Inpatient Care Manager serves as an educational resource for medical and hospital staff on admission status, acute care criteria, utilization management, care coordination, discharge planning, and regulatory requirements. The position requires providing care appropriate to the ages served and applying knowledge of growth and development across the lifespan. This is a part-time position working every Saturday and Sunday from 7:00 a.m. to 7:30 p.m., for 24 hours per week. The listed pay range is $38.20–$57.30.

Requirements

Graduate of a Board of Nursing-approved nursing education program.
Current RN license or temporary license as a Registered Nurse Petitioner in the state where the employee works and resides, or meet applicable licensure requirements for the employee’s home state under the National License Compact; for non-compact states, hold a current RN license or temporary license as applicable.
Typically requires 3 years of related nursing experience.
Clinical experience within the assigned population.
Extensive knowledge of disease processes and clinical outcomes.
Ability to prioritize and organize work.
Effective communication skills.
Ability to use critical thinking and make timely decisions.
Ability to navigate the Electronic Health Record.
Basic ability to use MS Office products.
Knowledge of Medicare A and B guidelines.
Knowledge of Managed Care program requirements and implications.
Ability to apply elements of Utilization Management programs.
Ability to sit for up to approximately 50 percent of the workday and stand and walk the equivalent of several blocks at a time.
Ability to lift up to 10 pounds continuously, up to 20 pounds frequently, and up to 50 pounds occasionally.
Manual dexterity to operate a computer and calculator.
Visual acuity to review documents, computer screens, and medical records and record information accurately.
Verbal communication and hearing acuity sufficient to receive instructions and converse by standard telephone.
Functional speech and hearing sufficient for effective communication by telephone.

Nice To Haves

Bachelor of Science degree in Nursing (BSN).
Case Management experience or background.
Strong critical-thinking and analytical skills.
Appropriate professional certification, preferred within 3 years of hire.

Responsibilities

Conduct complete assessments, establish appropriate plans, and initiate interventions within desired timeframes.
Collaborate with patients, families, and the healthcare team on care needs, discharge planning, and transitions while supporting patient choice and satisfaction.
Involve patients, families, and the team in decision-making throughout the hospital stay and use patient and family strengths in problem-solving.
Coordinate continuity of care and discharge planning in compliance with regulatory standards, ensuring relevant options and services are communicated in a timely manner.
Facilitate smooth transitions when patients are transferred.
Provide case management related to healthcare levels, finances, housing, family discord, and illness adjustment within the department’s scope.
Manage family dynamics and crisis situations professionally and promptly; use community resources and educate patients and families about accessing services.
Initiate internal and external referrals to support timely care progression and transitions.
Document discharge-planning interventions and utilization review activity according to department and medical-center standards.
Conduct and document accurate, timely concurrent and retrospective reviews using approved criteria.
Communicate with the healthcare team and partner with Social Work and unlicensed support personnel to establish and implement safe care plans.
Participate actively in the MDR and work with medical staff, hospital departments, and ancillary services to identify and resolve discharge barriers, expedite care, and coordinate care-management activities.
Collaborate with managers, physicians, medical directors, advisory groups, and treatment teams on physician practices and best practices for patient care plans.
Refer cases to a physician advisor when needed to support efficient care progression, accurate status, and regulatory compliance.
Maintain knowledge of healthcare regulations, reimbursement, length-of-stay impacts, and community resources.
Perform utilization management activities as required, including providing clinical updates to payers or external review organizations, collecting data, coordinating denial activity, supporting UM activity, and managing avoidable delays.
Deliver CMS regulatory notices within established timeframes, as applicable to site guidelines.
Develop and maintain productive relationships with community agencies and networks, representing Advocate Health Care positively and collaborating to meet patient and family needs.
Collaborate with Advocate Ambulatory Care Management and Continuing Health to meet shared goals and outcomes.
Educate and serve as an expert resource to medical and hospital staff on admission status, acute care criteria, utilization management, care coordination, discharge planning, and relevant regulatory requirements.
Demonstrate knowledge and skills necessary to provide age-appropriate care and assess and interpret information relevant to patients’ age-specific needs.
Perform other related duties as required.