RN Ambulatory Care Manager

Intermountain Healthcare Inc.; United States; On-site; USD 62,000 - 92,000; Full time

Benefits offered by this job

PEAK education program

Job summary

Intermountain Health is seeking a Central Market nurse care manager at the Salt Lake Clinic. You will collaborate with physicians and the care team to improve health for patients with chronic conditions, educate patients and caregivers, coordinate services, and balance clinical quality with cost management.

The role requires RN license, BSN within three years, and two years of clinical nursing experience. Preference for BSN, Case Management Certification, and care management experience with

Qualifications

• RN license in state of practice.
• BSN within three years of hire or promotion.
• Two years of clinical nursing experience.
• Preferred: BSN from accredited program.
• Case Management Certification.
• Experience in clinical care management or with third party payers.
• Knowledge of care management and health insurance products.
• Knowledge of coding, episode of care and length of stay guidelines.
• Strong written and verbal communication skills.

Responsibilities

• Identify patient populations using screening criteria and referrals per policy.
• Review medical records and referral information to gather data.
• Interview patient/family/SO to obtain information.
• Assess patient per COP/NCQA standards.
• Develop and maintain a plan of care for members.
• Create care plans using established evidence-based models.
• Coordinate communication among patient, caregivers, healthcare team and others.
• Intervene to resolve barriers to service across the care continuum.
• Maintain knowledge of community resources.
• Perform cost-benefit analyses and coordinate as needed.
• Other clinical duties as assigned.

Skills

Communication skills

Care management knowledge

Health insurance knowledge

Coding knowledge

Computer literacy

Education

BSN degree

RN license

Job description

Job Description

The Central Market nurse care manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs. The position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication, coordinates services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management.

Job Specifics

Benefits Eligible: Yes FTE: Full time Shift: Monday - Friday 8:00am - 4:30pm, 2 days a week in clinic. Location: Salt Lake Clinic.

Job Essentials

• Identifies patient populations using specific screening criteria, medical record review or through referrals for service per department policy/guidelines includes trigger list, timeframes for assessing patient, and pre-screen criteria.
• Review of medical records, focused reports and/or referral information to gather relevant data per department guidelines.
• Obtains additional necessary information by interviewing the patient/family/significant other (SO).
• Assesses patient/member per CMS Condition of Participation (COP) or National Clinical Quality Association (NCQA) standards.
• Ensures a plan of care is developed and maintained for members receiving care management services consistent with COP/NCQA and department standards.
• Develops plan of care using established evidence-based care process models or care plans.
• Incorporates the member's individualized needs and goals during the episode of care and within the benefit plan throughout the care management process.
• Coordinates and facilitates communication among the member/caregivers /representative, members of the healthcare team, and other relevant parties (e.g. referral physicians, community organizations, post-acute providers, other payers, Sales Team, Employer Groups, etc.).
• Care Management will actively intervene and resolve/escalate where barriers to service exist across the care continuum.
• Maintains a current knowledge of community resources.
• Where necessary performs cost benefit analysis and coordinates.
• Other clinical duties as assigned.

Minimum Qualifications

• RNs hired or promoted into this role need to have or obtain their BSN within three years of hire or promotion.
• Current RN license in state of practice.
• Two years of clinical nursing experience.

Preferred Qualifications

• Bachelor's degree in Nursing (BSN) from an accredited institution (degree will be verified).
• Case Management Certification.
• Experience working in clinical care management or with third party payers.
• Knowledge of care management.
• Knowledge of health insurance related products.
• Working understanding of coding, episode of care and length of stay guidelines.
• Written and verbal communication skills.
• Interact with others requiring the employee to communicate information.
• Operate computers and other office equipment requiring the ability to move fingers and hands.
• See and read computer monitors and documents.
• Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.

Location: Salt Lake Clinic

Work City: Salt Lake City

Work State: Utah

Scheduled Weekly Hours: 40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $45.31 - $67.01

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

All positions subject to close without notice.

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery. Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment.

Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment.

The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.

Thanks for your interest in continuing your career with our team!