RN Care Manager - Care Coordination

Endeavor Health•Arlington Heights, IL

2d•Onsite

About The Position

The RN Care Manager - Care Coordination role is responsible for facilitating payor authorization processes, ensuring accurate patient type assignment, and managing patient care across the continuum. This role involves collaborating with the CDI team to reflect the severity of illness and intensity of service in documentation, and working with the multi-disciplinary care team to ensure timely and appropriate patient progression. The RN Care Manager also addresses system problems that impede diagnostic or treatment progress, proactively resolves delays and obstacles to discharge to optimize length of stay, and seeks consultation from appropriate disciplines as needed. The position monitors patient progress, intervening to ensure the plan of care is patient-focused, high quality, efficient, and cost-effective.

Requirements

Current professional Nursing Licensure in the state of IL required
Bachelor's degree required.
Minimum of 2 years clinical nursing experience required
Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross).

Nice To Haves

Bachelor's degree in Nursing from a NLN accredited school of nursing is preferred.
Clinical certification, such as case management certification, is beneficial.
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.

Responsibilities

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.