Manager - Care Management

Evergreen Health; Kirkland (WA); On-site; USD 122,000 - 195,000; Full time

Benefits offered by this job

Medical, vision and dental insurance

On-demand virtual health care

Retirement plans 457(b) and 401(a)

Tuition assistance for undergraduate/​

Paid Time Off

Job summary

EvergreenHealth in Kirkland, WA, is seeking an RN Case Manager with leadership experience to coordinate case management, discharge planning and psychosocial services. The role ensures continuity of care across hospitalization and supports financial goals through compliant documentation and utilization management.

Ideal candidates have 3+ years in care management, a master's degree in Nursing or Social Work, and at least 2 years of supervisory responsibility, with active WA RN licensure and BLS

Qualifications

• Current license to practice as a Registered Nurse in Washington
• Master's degree in Nursing or Social Work or related field
• 3 years of care management experience
• 2 years supervisory/leadership experience in care management
• 5 years of Acute Care Hospital experience
• Current Healthcare Provider BLS – American Heart Association by start date
• Familiarity with payer requirements and regulatory standards
• Strong communication and relationship-building skills
• Financial stewardship for cost-effective care
• Ability to translate clinical knowledge to staff, patients and families

Responsibilities

• Facilitates patient care within policies, procedures and budget
• Guides Case Management RNs to ensure appropriate utilization and documentation
• Guides Social Workers for discharge planning and psychosocial services
• Maintains knowledge of payer requirements and EvergreenHealth services
• Leads Administrative Assistants for timely referrals
• Performs other duties as assigned

Job description

Wage Range: $121,846 - $194,938 per year

Posted wage ranges represent the entire range from minimum to maximum. For jobs with more than one level, the posted range reflects the minimum of the lowest level and the maximum of the highest level. Some positions also offer additional premiums based on shift, certifications or degrees. Job offers are determined based on a candidate's years of relevant experience, level of education and internal equity.

Job Summary:

Responsible for the functions of case management, discharge planning, psychosocial services, documentation integrity, utilization management and clinical outcomes. Assures continuity and coordination of care for patients before, during and after hospitalization, easing the transition for patients and families into and out of the hospital. The department contributes to the realization of financial goals for targeted case types, ensures appropriate clinical documentation and that payer conditions are met. Assumes 24-hour accountability and responsibility for area(s) assigned. Responsible for overall quality of service and for planning, developing, organizing, integrating, and directing programs, staff, and budget in support of the organizational goals and commitments.

Primary Duties:

1. Facilitates patient care including organization and management within established policies, procedures, standards of care, budgetary parameters and strategic objectives.
2. Provides guidance to Case Management RNs to assure appropriate utilization of services, level of care and documentation assuring fiscal integrity for the services provided to bedded patients.
3. Provides guidance to Case Management Social Workers to ensure proactive and complete discharge planning as well as the array of psychosocial services.
4. Maintains knowledge of payer requirements, community services, EvergreenHealth services and regulatory requirements.
5. Provides guidance to Administrative Assistants to assure timely facilitation of referrals.
6. Performs other duties as assigned.

License, Certification, Education or Experience:

REQUIRED for the position:

• Current license to practice as a Registered Nurse or LICSW in the state of Washington.
• Must hold Master's degree in Nursing,Social Work or related field.
• 3 years of care management experience
• 2 years supervisory, management or leadership experience in care management functions
• 5 years of Acute Care Hospital experience
• Current Healthcare Provider BLS – American Heart Association by start date
• Have knowledge of relevant computer systems; continuous quality improvement, and leadership process knowledge and skills.
• Must demonstrate ability to communicate clinical/education knowledge to staff, patients, and families.
• An understanding of financial management and a commitment to the provision of cost-effective care.
• Excellent customer relationship skills, interest and willingness to create and maintain relationships with all key customers, patients/families, physicians, payers, other departments, and outside agencies.

DESIRED for the position:

• Related certifications in Case Management

Benefit Information:

Choices that care for you and your family

At EvergreenHealth, we appreciate our employees’ commitment and contribution to our success. We are proud to offer a suite of quality benefits and resources that are comprehensive, flexible, and competitive to help our staff and their loved ones maintain and improve health and financial well-being.

• Medical, vision and dental insurance

• On-demand virtual health care
• Health Savings Account
• Flexible Spending Account
• Life and disability insurance
• Retirement plans 457(b) and 401(a) with employer contribution)
• Tuition assistance for undergraduate and graduate degrees
• Federal Public Service Loan Forgiveness program
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidaysVoluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits
• Cafeteria & Gift Shop Discount