Registered Nurse Care Manager

Department 11211 Advocate Lutheran General Hospital - Social Services: ACH Status Full time Benefits Eligible Yes Hours Per Week 40 Schedule Details/Additional Information Monday through Friday day shift with rotation and on call for weekends and holidays Pay Range $41.10 - $61.65 MAJOR RESPONSIBILITIES Conducts complete assessments, establishes appropriate plans, and initiates timely interventions. Collaborates and negotiates effectively with patient, family and team while striving to achieve patient and organizational goals regarding patient’s care needs, choice, and satisfaction when discharge planning/transitioning care. Works as a member of the multi-disciplinary care team in a collaborative and proactive manner to promote best practice. Conducts concurrent and retrospective clinical review based upon pre-established criteria approved by the medical staff for admission appropriateness and avoidable day(s) surveillance. Provides clinical updates for the purpose of obtaining certification to third party payers and fourth party external review groups, as stipulated in contractual agreements. Refers cases to physician advisor as needed to ensure accurate status and compliance with regulatory guidelines. Collects accurate data on outcomes and resource utilization issues and facilitates reporting of utilization monitoring/review activities to the appropriate committees/persons. Serves as an expert user of information technology platforms that support care management. Assists Manager with Human Resource responsibilities for staff which include interviewing and selecting new employees, promotions, staff development, performance evaluations, pay adjustments, resolution of employee concerns, disciplinary counseling, terminations, and employee morale. Provides general work direction and guidance to case managers. Serves as an educator and resource to staff regarding utilization issues, regulatory requirements, department policies and procedures. Collaborates with management in the development of new programs/services and updating current programs/services. Assists in the internal management of Care Management including assigning, assessing and overseeing staff caseloads in collaboration with the leader. Serves as liaison with physicians to address utilization management and care coordination issues. Monitors assigned area for efficient use of supplies and equipment. Determines appropriate clinical equipment needs and follows through on approvals, purchase and repairs as needed. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirements relative to his/her age‑specific needs, and to provide the care needed as described in the department’s. License/Registration/Certification Required Registered Nurse license issued by the state of practice and Accredited Care Manager (ACM) certification issued by the American Case Management Association (ACMA) needs to be obtained within 1 year, or Care Manager Certified (CMC) certification issued by the National Academy of Certified Care Managers (NACCM) needs to be obtained within 1 year, or Nurse Case Management (RN-BC) certification issued by the American Nurses Credentialing Center (ANCC) needs to be obtained within 1 year Education Required Bachelor’s Degree in Nursing. Experience Required Typically requires 5 years of experience in care management for a large, complex health care organization that includes experiences in an acute care setting. KNOWLEDGE, SKILLS AND ABILITIES REQUIRED Excellent oral and written communication skills. Interpersonal skills are essential to negotiate with patients, families, physicians, community agencies and third‑party payers for an optimum plan of care. Intermediate computer skills including word processing, presentation applications and electronic mail. Electronic medical record systems experience preferred. Demonstrated leadership skills in diplomacy, human relations, building rapport, collaboration, organization, prioritization, and promotion of staff development. PHYSICAL REQUIREMENTS AND WORKING CONDITIONS Must be able to sit up to approximately 50 percent of the workday; stand and walk for the equivalent of several blocks at a time. Must lift up to 10 lbs. continuously, up to 20 lbs. frequently, and up to 50 lbs. occasionally. Manual dexterity required for operation computer and calculator. Visual acuity required for facilitating review of written documents/computer screens, medical records, and to record information accurately. Clear verbal communications and hearing acuity required for receiving instructions and converse on standard telephone. Functional speech and hearing to allow for effective communication of instructions and conversation over the telephone. Exposed to normal office environment; including usual hazards related to operating electrical equipment. Operates all equipment necessary to perform the job. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our CommitmenttoYou Advocate Health offers a comprehensive suite of Total Rewards: benefits and well‑being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full‑time, part‑time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits. #J-18808-Ljbffr