RN Care Management Specialist NE-Cross Care Continuum

Posted:
9/3/2024, 6:34:03 AM

Location(s):
Highland Park, Illinois, United States ⋅ Illinois, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Medical, Clinical & Veterinary

Position Highlights:

  • Sign on bonus: (if applicable)
  • Position: RN Care Management Specialist
  • Location: Highland Park, IL
  • Full Time: 40 hours per week
  • Hours: Monday-Friday, with occasional weekends and 1 winter and 1 summer holiday required
  • Required Travel:

What you will need:

  • Bachelors degree required.  Bachelor’s degree in Nursing from an NLN accredited school of nursing is preferred.
  •  Minimum 2years clinical nursing experience preferred
  • Minimum two (2) years of utilization review, discharge planning, case management or disease management preferred. 
  • Knowledge of InterQual or MCG criteria is preferred.
  • Clinical certification, such as case management certification, is beneficial.
  • Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross) Able to communicate and work collaboratively with a range of stakeholders and team members
  • Knowledge of community resources
  • Experience with Microsoft Office Suite
  • Strong interpersonal and oral communication skills
  • Strong computer and data entry skills
  • Experience with Electronic Medical Record (EMR) platform preferred
  • Proven leadership skills
  • Ability to work independently, setting priorities to coordinate care plan efficiently

What you will do:

  • Facilitates payor authorization processes and ensures that the patient type assigned is accurate.
  • Facilitates the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement.
  • Works with the CDI team to ensure that documentation accurately reflects severity of illness and intensity of service.
  • Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient progression.
  • Addresses/resolves system problems impeding diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge so that length of stay is optimized.
  • Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
  • Monitors the patient’s progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective.
  • Facilitates the following on a timely basis:
  • Completion of discharge assessment and plan;
  • Modification of plan of care, as necessary, to meet the ongoing needs of the patient;
  • Communication to third party payors and other relevant information to the care team;
  • Assignment of appropriate levels of care
  • Partners with the healthcare team to ensure clinical decision-making, implementation of recommendations, and discharge planning are timely and appropriate.  Oversees and facilitates effective and impactful interdisciplinary rounds that are structured and standardized.

Benefits:

  • 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

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals – Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) – all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org.  

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to “help everyone in our communities be their best”. 

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.