RN Acute Case Manager - System Care Management - Full Time Day

Position Highlights

Up To $25,000 Sign On Bonus For Qualified RNs!

About the Role

This is a community case management position that provides patient-centered care while reducing avoidable healthcare costs, specifically preventable hospital admissions/ readmissions, and avoidable emergency room visits. The Care Manager has responsibility and accountability for coordinating all aspects of the patient’s care. A “Health Home” is a care management service model whereby all of an individual's caregivers communicate with one another so that all of a patient's needs are addressed in a comprehensive manner.

Responsibilities

• Collaborates to support that the right care is provided to patients in the right setting with a broad spectrum of health and community providers.
  • Works closely with the Medical Director and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.
  • Educates the physician and other healthcare team members regarding the coordination of care processes of the patient across the continuum of care.
  • Entity specific acute case manager may need to participate in an on-call system to ensure 24-hour accessibility and accountability to meet patient needs.
  • Serves as patient advocate in representing the patient’s best interests to the providers.
  • Procures insurance authorizations where indicated to ensure appropriate, cost effective care.
  • Acts as an institutional advocate by managing care in a cost-effective manner and communicating with third party payers.
• Collaborates to support that the right care is provided to patients in the right setting with a broad spectrum of health and community providers.
  • Works closely with the Medical Director and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.
  • Educates the physician and other healthcare team members regarding the coordination of care processes of the patient across the continuum of care.
  • Entity specific acute case manager may need to participate in an on-call system to ensure 24-hour accessibility and accountability to meet patient needs.
  • Serves as patient advocate in representing the patient’s best interests to the providers.
  • Procures insurance authorizations where indicated to ensure appropriate, cost effective care.
  • Acts as an institutional advocate by managing care in a cost-effective manner and communicating with third party payers.
• Collaborates to support that the right care is provided to patients in the right setting with a broad spectrum of health and community providers.
  • Works closely with the Medical Director and other members of the healthcare team to provide appropriate medical management and resource utilization utilizing established/approved criteria.
  • Educates the physician and other healthcare team members regarding the coordination of care processes of the patient across the continuum of care.
  • Entity specific acute case manager may need to participate in an on-call system to ensure 24-hour accessibility and accountability to meet patient needs.
  • Serves as patient advocate in representing the patient’s best interests to the providers.
  • Procures insurance authorizations where indicated to ensure appropriate, cost effective care.
  • Acts as an institutional advocate by managing care in a cost-effective manner and communicating with third party payers.

Qualifications

• Bachelor of Science degree in Nursing (BSN) or, a Bachelor of Arts (BA) degree in addition to a degree in Nursing.
• A registered nurse with five (5) years relevant experience willing to pursue a BSN or BA degree will be considered.
• Individual consideration may be given to a registered nurse, with significant clinical experience, who holds a bachelor’s degree in a related field.
• BSN or BA with a minimum of five (5) years relevant experience who demonstrates leadership and autonomy in nursing practice.
• a) Utilize critical thinking skills to create and or develop a clinical program or position and b) Demonstrated leadership skills for a licensed degree exception, there must be a significant depth of clinical experience: five (5) years of experience in an acute care setting with strong care management, utilization review, and payer knowledge.
• A Case Management certification or obtaining a Case Management certification within one (1) year of eligibility is encouraged.

Skills

• Utilize critical thinking skills to create and or develop a clinical program or position and b) Demonstrated leadership skills for a licensed degree exception, there must be a significant depth of clinical experience: five (5) years of experience in an acute care setting with strong care management, utilization review, and payer knowledge.
• A Case Management certification or obtaining a Case Management certification within one (1) year of eligibility is encouraged.

Benefits

The Guthrie Healthcare System Enterprise offers a comprehensive benefits package including health, dental, vision, life insurance, disability, and paid time off.

Pay

The pay range for this position is $37.50 - $53.06 per hour.

Schedule

The schedule for this position is typically full-time, but may vary based on the needs of the department.