Registered Nurse - Care Manager

Job Summary

Utilizes skilled intervention, clinical best practice knowledge and collaboration with the patient, physician and multidisciplinary treatment team to pace care, achieve quality outcomes and negotiate appropriate reimbursement. Ensures the timely and seamless clinical transition of patients through medically appropriate levels of care.

Job Responsibilities and Requirements

• Reviews all patients identified for review to determine the medical necessity and appropriateness of enrollment in the care management program.
• Affords support to assess all assigned patients and integrate family information from social work to collaboratively determine potential, actual and the next level of care needed.
• Holds, interprets, and integrates the patient’s story into the overall multidisciplinary plan of care.
• Collaborates with physicians, nursing, social work, and multiple disciplines, departments, payers, and agencies to eliminate barriers to efficient delivery of care in the appropriate setting.
• Participates in clinical performance improvement activities as assigned.
• Builds a network of positive working relationships that advocate for the patient.
• Documents clinical activity in the medical record and supports and coaches accurate clinical documentation by physicians and others.
• Pursues continuing education in area of expertise/leadership.
• Works in a constant state of alertness and safe manner.
• Performs other duties as assigned.

Education and Experience

• Graduate of accredited school of nursing or education equivalency for licensing.
• Two years' registered nurse experience.

Physical Requirements

• Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
• Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
• Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
• Frequent use of hearing and speech to share information through oral communication.
• Ability to hear alarms, malfunctioning machinery, etc.
• Frequent keyboard use/data entry.
• Occasional bending, stooping, kneeling, squatting, twisting and gripping.
• Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
• Rare climbing.

Required Professional License and/or Certifications

• Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR)
• Registered Nurse (RN) - Missouri Division of Professional Registration

Work Shift

Day Shift

Department

8149000125 Value Based Care

Scheduled Weekly Hours

40

Benefits

• Paid Parental Leave: one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
• Flexible Payment Options: voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
• Upfront Tuition Coverage: provides upfront tuition coverage through FlexPath Funded for eligible team members.

Company Information

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law.