RN Care Manager - Care Coordination - Days

What you will do

• Oversees and manages efficient patient flow for the unit by facilitating collaboration between nursing and interdisciplinary teams involved in the patient care plan including physicians, the Hub, mid-level providers, utilization management, and other ancillary and support services departments as required to identify and resolve issues that affect patient progression and the team.
• Coordinates the advancement of assigned patient's plan of care with patients, families, staff nurses and physicians for appropriate sequencing of care and interventions while providing oversight to ensure appropriate clinical pathways, protocols and standards of care are initiated and followed. Collaborates with physicians and, based on patient care plan and condition, recommends appropriate consults or ancillary services that advance patient progression. Works with the entire care team to ensure the patient is receiving the appropriate level of care and progressing according to plan.
• Conducts initial and continued patient stay reviews by monitoring assigned patient's care plan, status (inpatient, outpatient, and observations) and length of stay (LOS) targets for changes and confers with staff nurses, physicians, utilization management and clinical documentation specialists to ensure DRG assignments and length of stay targets are accurately reflected in the electronic medical record as patient conditions change. Maintains awareness of resource utilization on assigned patients and correlates to the clinical plan of care. Collaborates with utilization management, clinical documentation specialists and the HUB team to assist in managing any discrepancies in the consumption of resources related to the patients clinical, regulatory, or length of stay aspects of care.
• Develops and implements proactive patient discharge plans upon admission in conjunction with physicians, staff nurses, utilization management, and social worker according to patient needs and payor requirements. In conjunction with the Staff Nurse and Social Worker, initiates the development of patient discharge plans for complex patients and works with the utilization management team to eliminate discharge barriers as needed.
• Jointly leads daily 'Status-Now-Action-Planning' (SNAP) Huddles and participates in multi-disciplinary meetings as appropriate, and escalates any and all barriers to leadership.
• Coordinates with leadership, unit staff, educators and support departments to ensure compliance with government and commercial payer regulations and incorporating the Utilization Review Management Policy in initial reviews and continued stay reviews.
• Consults with utilization management and clinical documentation specialists to serve as an expert resource to unit based staff and physicians regarding patient status and placement, utilization of resources and general payer requirements.

What you will need:

• Bachelor's of Science in Nursing required.
• Current licensure to practice nursing in the State of Illinois.
• Two years of experience in an acute care setting required, specialty requirements vary by unit.
• Previous leadership experience required.
• General knowledge of case management processes including discharge planning, health care reimbursement, utilization review process, and applicable community resources preferred.
• Case management certification required or obtained within one year of eligibility.

Benefits:

• Eligibility for our Annual Incentive Plan, which offers the potential to earn a certain percentage amount of your base salary based on organizational performance. (For AIP eligible positions)
• Premium pay for eligible employees
• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• 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.