RN Care Manager

Location: Highland Park, IL
Full Time: 40 hours per week

Schedule

• Monday–Friday, 8:30 AM–5:00 PM
• Rotating weekends
• 1 winter and 1 summer holiday coverage required

Pay

Hourly Pay Range: $40.45 – $62.70. The hourly pay rate offered is determined by a candidate’s expertise and years of experience, among other factors.

Requirements

• Current professional Nursing Licensure in the state of IL
• Bachelor’s degree required; Bachelor’s degree in Nursing from a NLN-accredited school of nursing preferred
• Clinical certification (e.g., case management certification) beneficial
• Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross)
• Minimum of 2 years clinical nursing experience
• Previous experience in Utilization Management, Managed Care, or chronic disease management highly preferred
• Experience with Electronic Medical Record (EMR) platform preferred
• Knowledge of InterQual or MCG criteria preferred

Responsibilities

• Facilitate payor authorization processes and ensure accurate patient-type assignment
• Collaboratively manage patient care across the continuum, removing barriers to timely and efficient care delivery and reimbursement
• Work with the CDI team to ensure documentation accurately reflects severity of illness and intensity of service
• Maintain active communication with physicians, nursing, and other multidisciplinary care team members to effect timely, appropriate patient progression
• Address and resolve system problems impeding diagnostic or treatment progress
• Proactively identify and resolve delays and obstacles to discharge to optimize length of stay
• Seek consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge
• Monitor patient progress, intervening as necessary to ensure the plan of care and services provided are patient-focused, high-quality, efficient, and cost-effective

Benefits

• Premium pay for eligible employees
• Career pathways to promote professional growth and development
• Various medical, dental, and vision options
• Tuition reimbursement
• Free parking at designated locations
• Wellness program savings plan
• Health savings account options
• Retirement options with company match
• Paid time off
• Community involvement opportunities