RN Care Management, 0.9 FTE, Days

About the role

PeaceHealth is seeking an experienced RN Care Manager to join our collaborative care team. In this impactful role, you'll help guide patients through their healthcare journey by coordinating care, facilitating smooth transitions, and advocating for the resources they need to achieve the best possible outcomes.

The salary range for this position is $45.78 to $82.98 per hour, with compensation determined by experience and applicable collective bargaining agreements. This position is represented by a collective bargaining agreement. There may be multiple openings available. Relocation assistance may be available.

Responsibilities

• Coordinate and facilitate comprehensive discharge planning for patients throughout their hospitalization and transition to post-acute care settings.
• Assess patients' clinical, psychosocial, environmental, financial, and support needs to develop individualized plans of care.
• Partner with patients, families, providers, and interdisciplinary teams to ensure effective care coordination and resource utilization.
• Review admissions and level-of-care determinations using established clinical criteria and regulatory guidelines.
• Monitor and support appropriate utilization of healthcare services while maintaining high standards of patient care.
• Communicate with insurance providers and third-party payors to obtain authorizations and resolve coverage-related concerns.
• Advocate for patients by identifying barriers to care and connecting them with appropriate community and healthcare resources.
• Facilitate interdisciplinary care meetings focused on quality outcomes, patient satisfaction, and efficient care delivery.
• Ensure accurate documentation to support clinical decisions, continued hospitalization, utilization review requirements, and reimbursement.
• May support palliative care initiatives, including symptom management coordination, family meetings, comfort care planning, and POLST discussions.

Requirements

• Graduate of an accredited School of Nursing.
• Current Registered Nurse (RN) license in the state of practice.
• Basic Life Support (BLS) certification upon hire.
• Minimum of three years of clinical nursing experience in an acute care hospital setting. Equivalent experience in skilled nursing, outpatient case management, home health, or hospice may also be considered.

Qualifications

• Bachelor of Science in Nursing (BSN) or Master of Science in Nursing (MSN).
• Utilization management and/or quality management experience.
• Specialty nursing certification.
• Knowledge of third-party reimbursement processes.

Skills

• Strong care coordination and patient advocacy skills.
• Ability to build positive relationships with patients, families, providers, and community partners.
• Excellent communication and collaboration abilities.
• Critical thinking and problem-solving skills in complex clinical situations.
• Effective prioritization and organization in a fast-paced environment.
• Working knowledge of Microsoft Office applications and electronic medical records.

Benefits

• Medical, dental, and vision coverage
• 403(b) retirement plan with employer contributions and matching
• Generous paid time off
• Employer-paid life and disability insurance
• Tuition reimbursement and continuing education support
• Wellness programs and resources
• Expanded Employee Assistance Program and mental health benefits