RN Care Management (Full-time)

Norwegian American Hospital; Chicago (IL); On-site; USD 75,000 - 95,000; Full time

Job summary

Norwegian American Hospital is seeking an experienced RN Case Manager to coordinate care across the continuum, support utilization management, and discharge planning for diverse patient populations. The role emphasizes collaboration with the healthcare team, assessment and planning, and ensuring patients receive appropriate level of care while meeting clinical and financial goals.

You will participate in rounds, maintain documentation, and adapt to fast-paced environments with strong

Qualifications

• Current IL RN licensure required.
• RN degree (BSN) preferred.
• Experience in Utilization Management and case management preferred.
• 5+ years minimum in acute nursing experience.
• BLS Required.
• Strong collaboration and communication skills.
• Knowledge of CMS and payer requirements.
• Able to work in fast-paced environment with interruptions.

Responsibilities

• Coordinate care across the continuum and ensure appropriate level of care.
• Participate in patient care rounds and promote interdisciplinary collaboration.
• Assess, plan, implement, monitor, and evaluate care options.
• Determine medical necessity and manage transitions of care.
• Document utilization review and care coordination activities.

Skills

Case management

Utilization management

Care coordination

Discharge planning

Interdisciplinary collaboration

Communication skills

Time management

EHR systems

CMS knowledge

Financial/reimbursement understanding

Clinical assessment

Education

IL RN licensure

Bachelor’s degree in Nursing (BSN) preferred

Tools

EHR systems

Job description

The RN Case Manager carries out activities related to utilization management, discharge planning, and care coordination. Participates in patient care rounds and promotes interdisciplinary collaboration with all team members. ensure patient needs are met and care delivery is coordinated across the continuum at the appropriate level of care He/she clinically assesses, plans, implements, coordinates, monitors, and evaluates options and services through effective care coordination and utilization of healthcare resources in order to achieve desired clinical and financial goals.

Key responsibilities include determination of medical necessity, ability to partner with the healthcare team to ensure all aspects of the patient’s needs, clinical, psychosocial and financial are adequately addressed in the transition of care plan and to manage the patient’s timely progression of care and safe transition to the next most appropriate level of care.

QUALIFICATIONS –

• Current IL RN licensure required
• RN Degree (Bachelor’s degree preferred)
• Experience and certification in case management preferred; case management certification expected within 2 years of hire
• Experience in Utilization Management
• 5 years minimum in acute nursing experience
• BLS Required
• Current sound clinical knowledge; knowledge of medical literature, research methodology, financial/ reimbursement issues
• Strong collaboration, communication and interpersonal skills
• Excellent organizational and time management skills
• Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems
• Desire to work collaboratively and proactively with healthcare teams and other hospital-based interdisciplinary teams
• Current knowledge of discharge planning, resource management, utilization review and care coordination in an acute care setting
• Knowledge of CMS, commercial payer requirements and hospital financial/reimbursement processes
• Excellent written/verbal communication skills, critical thinking skills, creative problem-solving skills, good organizational and planning skills
• Must be self-directed, have the ability to tolerate frequent interruption and work in a fast-paced work environment
• Knowledge of funding, resources, services, clinical standards, care coordination processes and outcomes are preferred
• Weekend rotation will be required. Holiday and on call may be required

Equal Opportunity Employer
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