RN Care Manager - Care Coordination
$84,136–$130,416 year
On-siteElk Grove Village, Illinois, United States
Job Summary
Facilitate payor authorization processes and ensure accurate patient type assignments while managing patient care across the continuum to remove barriers to timely delivery and reimbursement. Collaborate with the CDI team to verify documentation severity and maintain active communication with physicians and the multi-disciplinary care team to optimize discharge and length of stay. Address system problems impeding diagnostic or treatment progress and seek consultation from appropriate disciplines to expedite care. Monitor patient progress to ensure the plan of care remains patient focused, high quality, efficient, and cost effective. Requires current Illinois nursing licensure, a Bachelor's degree, and minimum two years of clinical nursing experience.
Required Qualifications
- Current professional Nursing Licensure in the state of IL
- Bachelor's degree
- Minimum of 2 years clinical nursing experience
Desired Qualifications
- Bachelor's degree in Nursing from a NLN accredited school of nursing
- Clinical certification, such as case management certification
- Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross)
- Previous experience in Utilization Management, Managed Care or chronic disease management
- Experience with Electronic Medical Record (EMR) platform
- Knowledge of InterQual or MCG criteria
- Rotating every 3rd weekend
- 1 summer and 1 winter holiday coverage
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