Inpatient Care Manager

Advocate Health • Winston-Salem, NC

6d • $38 - $57

About The Position

The Inpatient Care Manager conducts patient assessments, develops care plans, and coordinates interventions and transitions of care. The role works with patients, families, and the healthcare team to support patient needs, choices, and satisfaction, and to establish safe, timely discharge plans. It provides case management and utilization management services, documents activities, coordinates referrals, and helps resolve barriers to care and discharge in accordance with department standards and regulatory requirements.

The position collaborates with medical staff, Social Work, hospital departments, ancillary services, community agencies, and other care management teams. It also provides guidance and education to medical and hospital staff on admission status, acute care criteria, utilization management, care coordination, discharge planning, and relevant regulations. The incumbent must provide care appropriate to the age-specific needs of patients served.

This is a full-time position scheduled Monday through Friday, 8:00 a.m. to 5:00 p.m., for 40 hours per week. The listed pay range is $38.20–$57.30.

Requirements

• Graduate of a Board of Nursing-approved nursing education program (RN).
• Current RN license or temporary license as a Registered Nurse Petitioner in the state where the employee works and resides, subject to the stated National License Compact requirements.
• Typically requires 3 years of related nursing experience.
• Clinical experience within the assigned patient population.
• Extensive knowledge of disease processes and clinical outcomes.
• Ability to prioritize and organize work.
• Effective communication skills.
• Critical thinking and timely decision-making skills.
• 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 meet the described physical requirements, including sitting, standing, walking, lifting, computer and calculator operation, visual review of records and screens, and clear verbal communication and hearing.

Nice To Haves

• Bachelor of Science 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 and negotiate with patients, families, and the care team to support care needs, choices, satisfaction, and organizational goals during discharge planning and care transitions.
• Involve patients, families, and the team in decision-making throughout the hospital stay, using patient and family strengths in problem-solving.
• Provide continuity of care and regulatory-compliant discharge planning, coordinating relevant options and services and facilitating smooth transfers.
• Provide case management related to healthcare levels, finances, housing, family discord, and illness adjustment within departmental scope; address crisis situations, use community resources, and educate patients and families about 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.
• Perform and document timely concurrent and retrospective reviews using established criteria.
• Communicate effectively with the healthcare team and partner with Social Work and unlicensed support personnel to establish and implement safe care plans.
• Participate in multidisciplinary rounds and work with medical staff, hospital departments, and ancillary services to identify and resolve discharge barriers, expedite care, and report care coordination, discharge planning, and utilization management activities.
• Collaborate with managers, physicians, medical directors, advisory groups, and treatment teams on physician practices and patient care plans; refer cases to physician advisors as needed.
• Stay informed about healthcare regulations, reimbursement, length-of-stay impacts, and community resources; complete utilization management activities, including clinical updates to payers or external review organizations, data collection, denial coordination, and management of avoidable delays.
• Deliver CMS regulatory notices within required timeframes, as appropriate to site guidelines.
• Develop productive relationships with community agencies and networks and collaborate with Advocate Ambulatory Care Management and Continuing Health.
• 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 regulatory requirements.
• Demonstrate knowledge of lifespan growth and development and assess and interpret patient information to meet age-specific care needs.
• Prioritize and organize work, communicate effectively, use critical thinking and timely decision-making, navigate the Electronic Health Record, and use MS Office products and utilization management principles.

Benefits

• Paid Time Off programs.
• Medical, dental, vision, life, and short- and long-term disability benefits.
• Flexible Spending Accounts for eligible healthcare and dependent care expenses.
• Adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.
• Competitive compensation, premium pay for eligible positions, incentive pay for select positions, and opportunity for annual performance-based increases.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree