KNOWLEDGE, SKILLS AND ABILITIES:

• Provides structure and assure consistent implementation of the CM plan, DM plan, SOPs and policies in all centers.
• Assists with creation and implementation of SOPs as appropriate.
• Precepts new case managers.
• Serves as resident CM and DM “expert” to consistently support CM needs for market specific education.
• Provides support for catastrophic cases within the clinical support group.
• Identifies problems or any dissatisfaction experienced by patients or referring source and works to resolve them to a high degree of service excellence.
• Builds relationships with preferred acute care providers (hospitalists, specialists).
• Attends meetings that require CM/DM participation relay information as needed to other market case managers.
• Assigns coverage for CM PTO/Open positions.
• Assists with quality audits; Analyzes case management/disease management outcomes to identify issues and make recommendations.
• Formulates, implements and evaluates educational strategies for staff, patient and family.
• Floats to other centers as needed.
• Inputs into case manager performance evaluations or direct supervisory authority as determined by market leadership.
• Assists in the interviewing, hiring and termination of case management staff.
• Assists with quality audits and data analyses to identify opportunities for improvement.
• Supports quality improvement initiatives.
• Serves as a resource for CM/DM process and documentation.
• Assists with patient complaints and follows to resolution.
• Performs other duties as assigned and modified at manager’s discretion.
• Analytical ability and comprehensive knowledge base to identify opportunities for improvement and problem resolution, evaluate patient status and health care procedures/techniques, and monitor quality of patient care.
• Verbal and written communication skills to communicate effectively with diverse populations including physicians, employees, patients and their families.
• Knowledge of care delivery capabilities along the continuum of care.
• Interpersonal skills necessary to work productively with all levels of hospital personnel and to supervise the activities of a group of employees. Strong interpersonal, communication and critical thinking skills are required.
• Resourcefulness to identify prompt and sustainable solutions to barriers in care delivery.
• Leadership skills to direct others toward objectives that contribute to the success of the department.
• Ability to cope with stressful situations, manage multiple and sometimes conflicting priorities simultaneously.
• Flexibility with schedule, including off-shifts, weekends and holidays to meet the needs of patients, families or staff.
• Teaching abilities to conduct educational programs for staff.
• Fiscal skills to monitor and control costs and revenue.
• Familiarity with professional and technical emerging knowledge.
• Problem solving skills and ability to multi-task.
• Compassionate with teamwork skills.
• Ability to supervise and train employees, to include organizing, prioritizing, and scheduling work assignments.
• Excellent knowledge of case management principles, healthcare management and reimbursement.
• Previous experience with psychological aspects of care.
• Excellent organizational and time management skills.
• Proficient in Microsoft Office Suite products including Excel, Word, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software.
• Ability and willingness to travel locally, regionally and nationwide up to 10% of the time.
• Spoken and written fluency in English.
• Bilingual preferred

EDUCATION AND EXPERIENCE CRITERIA:

• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
• Critical thinking skills required.
• Ability to work autonomously is required.
• Ability to monitor, assess and record patients’ progress and adjust and plan accordingly.
• Understanding utilization review and how to leverage with inpatient staff for possible reduction of medical cost on long length of stay patients.
• Ability to plan, implement and evaluate individual patient care plans.
• Knowledge of nursing and case management theory and practice.
• Knowledge of patient care charts and patient histories.
• Knowledge of clinical and social services documentation procedures and standards.
• Knowledge of community health services and social services support agencies and networks.
• Organizing and coordinating skills.
• Ability to communicate technical information to non-technical personnel.
• Proficient in Microsoft Office Suite products including Excel, Word, PowerPoint, and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software.
• Ability and willingness to travel locally, regionally, and nationwide up to % of the time.
• Spoken and written fluency in English, bilingual preferred.
• Associate degree in Nursing required.
• Bachelor’s Degree in nursing (BSN) or RN with bachelor’s degree in a related clinical field preferred.
• A valid, active Registered Nurse (RN) license in State of employment required.
• A minimum of 2 years’ clinical work experience required.
• A minimum of 1 year of utilization review and/or case management, home health, hospital discharge planning experience required.
• A minimum of 1 year of case management experience in acute case management or community case management experience highly desired.
• This position requires possession and maintenance of a valid driver's license.
• Certified Case Manager certification is preferred. Certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) desired.

Job Type: Full-time

Pay: $45.00 - $50.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Mileage reimbursement
• Paid sick time
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work setting:

• Clinic
• Hospital
• Outpatient

Application Question(s):

• Do you have a minimum of 2 year’s acute case management or community case management experience conducting assessments of patients' medical conditions, needs, and resources, collaborating with physicians, nurses, and other support staff, to ensure a seamless and coordinated delivery of care, if so, please describe your experience in full detail?
• Do you have 2 years or more utilization review or case management experience monitoring the utilization of healthcare resources to ensure efficiency and cost-effectiveness in a home health or hospital environment if so please describe your experience in full detail?
• Do you have 2 years of experience advocating for patients' needs and rights, ensuring that they receive appropriate and timely care, developing and implementing discharge plans for patients, and ensuring that patients have the necessary support and resources for a smooth transition from acute care to other settings if so please describe your experience?
• Do you have a bachelor’s degree in nursing (BSN) or RN with bachelor’s degree in a related clinical field?
• Do you have a valid active RN in the state where the job is in?
• Do you have any of the listed certifications Certified Case Manager Certification (CCMC) ) or a Certification Managed Care Nurses (CMCN) if so please list which certification(s) that you have?
• Do you have a valid driver’s license and access to a car that you can use daily?

Ability to Commute:

• Chicago, IL 60617 (Preferred)

Work Location: In person