RN Care Manager - Care Coordination

Responsibilities

• Manage the authorization process and ensure correct patient classification.
• Collaborate across care teams to promote timely and efficient patient care and reimbursement.
• Support documentation to accurately reflect illness severity and care services.
• Communicate actively with physicians, nurses, and multidisciplinary teams to ensure patient progression.
• Identify and resolve system barriers, delays, and obstacles to discharge, optimizing length of stay.
• Monitor patient progress and intervene to ensure high-quality, cost-effective care.

Qualifications & Skills

• Current IL Nursing License required.
• Bachelor's degree in Nursing; NLN-accredited preferred.
• Clinical certification (e.g., case management) is a plus.
• Minimum of 2 years clinical nursing experience, with preferred background in Utilization Management, Managed Care, or chronic disease management.
• Experience with Electronic Medical Records (EMR) and knowledge of InterQual or MCG criteria preferred.