Population Health RN Case Manager

University of Colorado•Hybrid, CO

4d•$83,794 - $100,552•Hybrid

About The Position

The Population Health RN Case Manager works collaboratively with physicians, interdisciplinary teams, patients, and families to promote positive patient outcomes. Performs a care continuum process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to support the individual’s health needs, utilizing skilled communication, education, and resources to promote quality and cost-effective outcomes. Provides focused support to various areas such as utilization management, value-based performance team, emergency department, acute, ambulatory, and specialty care teams. Duties include assessment to identify member needs and development of a specific care management plan to address past, present, and ongoing care needs. In conjunction with the Physician, implements care/treatment plan by coordinating access to health services across multiple providers/ disciplines, monitors care, makes determination to arrange transportation and transfer patient if indicated, identifies cost-effective measures, makes recommendations for alternative levels of care and utilization of resources, promotes medication management, telehealth/remote care options, self-care management, and ensures paperwork is completed. Is an indirect caregiver.

Requirements

Bachelor’s degree in nursing, biological science, or a directly related field from an accredited institution.
Two (2) years of registered nurse experience in a clinical/hospital setting.
One (1) year of experience in case management in specialty area.
Applicants must meet minimum qualifications at the time of hire.
Applicants must be legally authorized to work in the United States without requiring sponsorship. We are unable to provide work visa sponsorship or employment authorization for this position now or in the future.
Registered Nurse (RN), State of Colorado.
Current Basic Life Support (BLS) for Healthcare Providers issued by the American Heart Association or the American Red Cross healthcare provider level CPR certification.
Maintains all required licensure and certifications for the position.
Maintains all required continuing education requirements.
Must be able to work in-person or have reliable internet for remote work, as approved.
Must be able to travel/cover to alternate locations as assigned.
Ability to communicate effectively, both in writing and orally.
Ability to establish and maintain effective working relationships with employees at all levels throughout the institution.
Outstanding customer service skills.
Ability to effectively communicate at all levels, to include physicians, leadership, and staff within the various affiliate organizations (UCH, Children’s Colorado, CU Medicine, CU SOM).
Ability to work within large, complex healthcare systems.
Ability to analyze and interpret data.

Nice To Haves

Three or more (3+) years registered nurse experience in a clinical/hospital setting.
Two or more (2+) years of experience in case management in specialty area.
Bilingual, Spanish-speaking.
Nursing certification (ANCC) in specialty area.
Kronos, Epic, and Health Stream experience.

Responsibilities

Interfaces with Primary Care Physicians, Specialists, and various disciplines on the development of case management plans/programs.
Monitors and evaluates the effectiveness of the case management plans and modifies as necessary.
Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, value-based care, and transfer coordination, discharge planning, and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.
Acts as a clinical liaison, per their specialty, with outside agencies and facilities, outside providers, employers, and/or workers' compensation carriers and third-party administrators.
Acts as a patient advocate and educator to ensure that the patient has the knowledge to care for his/her condition and is educated and empowered to be responsible for participating in the plan of care.
Prepares reports, communicates program changes to appropriate staff, and develops protocols in accordance with state regulations.
Develops and updates training and educational materials and presents to appropriate staff, patients, and families.