RN Care Manager - Surgery & Cardiac Services

UNC REX Healthcare; Chapel Hill (NC); On-site; USD 75,000 - 107,000; Full time

Job summary

UNC Medical Center is seeking an experienced Care Manager RN to provide comprehensive and coordinated care, performing care assessments, developing patient-centered care plans, and guiding care transitions across settings. The role emphasizes risk segmentation, payer communication, and collaboration with the care team to ensure high-quality outcomes.

The position offers a 40-hour work week with weekend and holiday rotations, no night shifts, and no on-call requirements, located onsite in Chapel

Qualifications

• Graduation from a state accredited school of professional nursing.
• Magnet hospitals: BSN required or must be enrolled in an accredited program within 4 years of employment and obtain a bachelor’s degree with a major in nursing or a master’s degree with a major in nursing within 7 years of employment date.
• Registered Nurse with a valid license to practice in North Carolina.
• Minimum of 2 years of experience as a registered nurse.

Responsibilities

• Conduct comprehensive care manager assessments utilizing standardized assessment tools and nursing knowledge to evaluate patients' functional abilities, cognitive status, and psychosocial support systems.
• Collaborate with providers, patients, their families, and the healthcare team on individualized care plans that align with patients' goals, preferences, and values.
• Utilize standardized tools and clinical judgment to identify and assess the risk level of patients based on medical conditions, social determinants of health, and behavioral health needs.
• Coordinate and facilitate necessary tasks or interventions to support patients' care plans and coordinate with community resources to ensure seamless care.
• Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely approvals for necessary care and services.
• Accurately document and bill for services rendered, as applicable, in compliance with insurance and regulatory requirements.
• Act as a key point of contact and advocate for patients within the care team, providing ongoing support and care coordination throughout the patient’s healthcare journey.

Skills

Risk segmentation

Patient assessments

Care planning

Care transitions

Payer communication

EHR proficiency

Team collaboration

Education

State-accredited nursing school

BSN or higher program enrollment within 4 years (Magnet emphasis)

Job description

Description

Have you ever considered a role in Care Management?

UNC Medical Center is the place for you!

What is the schedule?

• 40 hrs/week
• Weekend rotation
• Holiday rotation
• No Nights
• No on-call

Who are we looking for? Experienced RNs who:

• Have at least 2 years of RN experience (preferably in Cardiac, Surgery, and Trauma/Burns)
• Have an interest in driving a safe discharge process
• Enjoy advocating for patient needs and care progression
• Thrive in a team environment
• Would like to learn how to be a Care Manager or would like to continue their Care Manager career at UNC Medical Center

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Summary:
The Care Manager RN plays a crucial role in providing comprehensive and coordinated care to patients within UNC Health. This position involves utilizing a variety of skills, including risk segmentation, patient assessments, patient-centered care plans, tasks or interventions, care transitions, delegated work, and payer communication. The Care Manager works collaboratively with healthcare providers, patients, and their families to ensure that patients receive the highest quality of care and support throughout their healthcare journey.

Responsibilities:
1. Patient Assessments:
a. Conduct comprehensive care manager assessments utilizing standardized assessment tools and nursing knowledge to evaluate patients' functional abilities, cognitive status, and psychosocial support systems.
b. Identify any barriers to care and develop appropriate interventions to address them.
2. Patient-Centered Care Plans:
a. Collaborate with providers, patients, their families, and the healthcare team on individualized care plans that align with patients' goals, preferences, and values.
b. Ensure that care plans are evidence-based, culturally sensitive, and promote patient engagement and self-management.
3. Risk Segmentation:
a. Utilize standardized tools and clinical judgment to identify and assess the risk level of patients based on various factors such as medical conditions, social determinants of health, and behavioral health needs.
b. Develop strategies to effectively manage and mitigate risks for patients, ensuring their overall well-being and optimal health outcomes.
4. Tasks or Interventions: a. Coordinate and facilitate necessary tasks or interventions to support patients' care plans.
b. Collaborate with healthcare providers, community resources, and support services to ensure seamless coordination of care.
c. Advocate for patients' needs and rights, ensuring that they receive appropriate and timely interventions. d. Participates in quality improvement initiatives to ensure patient, departmental, and organizational goals/outcomes are met or exceeded.
5. Care Transitions: a. Coordinate and facilitate care across various healthcare settings, ensuring seamless transitions and continuity of care.
b. Communicate and collaborate with healthcare providers, specialists, and community resources to ensure comprehensive and coordinated care delivery.
c. Facilitate multidisciplinary care team meetings to discuss patients' care plans and progress.
6. Coordinated Work:
a. Coordinate care management tasks with other members of the healthcare team while maintaining accountability for the overall coordination and management of patients' care as applicable per patient population.
7. Payer Communication:
a. Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely approvals for necessary care and services.
8. Accurately document and bill for services rendered, as applicable, in compliance with insurance and regulatory requirements.
a. Collaborate with billing and coding professionals, as applicable, to ensure compliance with coding and documentation requirements.
9. Longitudinal Care as part of the Medical Home (varies per patient population and care setting):
a. Act as a key point of contact and advocate for patients within the care team.
b. Provide ongoing support and care coordination throughout the patient's healthcare journey, ensuring continuity and comprehensiveness of care.

Other Information

Other information:

Education Requirements:

• Graduation from a state accredited school of professional nursing
• Magnet hospitals: BSN required or must be enrolled in an accredited program within 4 years of employment and obtain a bachelor’s degree with a major in nursing or a master’s degree with a major in nursing within 7 years of employment date.

Licensure/Certification Requirements:

• Registered Nurse with a valid license to practice in North Carolina.

Professional Experience Requirements:

• Minimum of 2 years of experience as a registered nurse.

Knowledge/Skills/and Abilities Requirements:

• Strong knowledge of risk segmentation, patient assessments, patient-centered care planning, care transitions, and payer communication.
• Excellent communication, collaboration, and problem‑solving skills.
• Ability to work independently and as part of a multidisciplinary team.
• Proficiency in electronic health records (EHR) and other relevant software applications.

Job Details

Legal Employer: STATE

Entity: UNC Medical Center

Organization Unit: UNCH Care Mgmt-Medical Center

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range:$35.87 - $51.57 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: Yes

This is a State position employed by UNC Health Care System with UNC Health benefits. If, however, you are presently an employee of another North Carolina agency and currently participate in TSERS or the ORP, you will be eligible to continue participating in those plans at UNC Health.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation. UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [e-mail] if you need a reasonable accommodation to search and/or to apply for a career opportunity.