RN Care Management (Full-time)
On-siteChicago, Illinois, United States
Job Summary
Conduct utilization management, discharge planning, and care coordination while participating in patient care rounds and promoting interdisciplinary collaboration. Clinically assess, plan, implement, and evaluate options and services to achieve desired clinical and financial goals. Determine medical necessity and manage the patient's timely progression of care and safe transition to the next appropriate level of care, ensuring all clinical, psychosocial, and financial needs are addressed. Requires current IL RN licensure, acute care experience, and weekend rotation. Weekend rotation will be required. Holiday and on call may be required.
Required Qualifications
- Current IL RN licensure
- RN Degree
- Experience and certification in case management
- case management certification expected within 2 years of hire
- Experience in Utilization Management
- 5 years minimum in acute nursing experience
- BLS
- Current sound clinical knowledge
- knowledge of medical literature
- research methodology
- financial/ reimbursement issues
- Strong collaboration, communication and interpersonal skills
- Excellent organizational and time management skills
- Knowledge of computers
- Electronic Health Records
- data base systems
- utilization review/case management documentation systems
- Desire to work collaboratively and proactively with healthcare teams and other hospital-based interdisciplinary teams
- Current knowledge of discharge planning
- resource management
- utilization review
- care coordination in an acute care setting
- Knowledge of CMS
- commercial payer requirements
- hospital financial/reimbursement processes
- Excellent written/verbal communication skills
- critical thinking skills
- creative problem-solving skills
- good organizational and planning skills
- Must be self-directed
- have the ability to tolerate frequent interruption
- work in a fast-paced work environment
- Current knowledge of funding
- resources, services, clinical standards, care coordination processes and outcomes
- Weekend rotation
- Holiday and on call
Desired Qualifications
- Bachelor's degree preferred
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