RN Case Mgr-Hospital & ED-M-M

Children's Minnesota; Minneapolis (MN); On-site; USD 75,000 - 110,000; Full time

Job summary

Children's Minnesota is seeking an RN Case Manager to support pediatric patients across the care continuum. You will promote efficient service delivery, coordinate the plan of care, and ensure medical necessity and appropriate resource utilization.

You will collaborate with physicians, payers, families, and the care team to move care through episodes, monitor outcomes, and mentor colleagues. BSN or ADN with BS/BA in relevant health care field required; pediatric experience preferred.

Qualifications

• Demonstrated ability to gather data, evidence, and best practice to present a cogent argument to physicians and payers.
• Ability to challenge respectfully and negotiate for optimal patient outcomes.
• Demonstrated problem solving, data-driven recommendations and clinical knowledge.

Responsibilities

• Coordinate patient care plans and ensure standard of care and outcomes.
• Communicate with healthcare team and payers to verify medical necessity and payer information.
• Move care through episodes of care efficiently and ensure appropriate resource utilization.

Skills

Data gathering

Team collaboration

Critical thinking

Negotiation

Coaching

Computer proficiency

Education

BS/BA in nursing or ADN with BS/BA in relevant health care major

Job description

About Children's Minnesota

Children's Minnesota is one of the largest pediatric health systems in the United States and the only health system in Minnesota to provide care exclusively to children, from before birth through young adulthood. An independent and not-for-profit system since 1924, Children's Minnesota is one system serving kids throughout the Upper Midwest at two free-standing hospitals, nine primary care clinics, multiple specialty clinics and seven rehabilitation sites. As The Kids Experts Children's Minnesota in our region, Children's Minnesota is regularly ranked by U.S. News & World Report as a top children's hospital. Find us on Facebook @childrensminnesota or on Twitter and Instagram @childrensmn. Please visit childrensMN.org.

About Children's Minnesota

Children's Minnesota is one of the largest pediatric health systems in the United States and the only health system in Minnesota to provide care exclusively to children, from before birth through young adulthood. An independent and not-for-profit system since 1924, Children's Minnesota is one system serving kids throughout the Upper Midwest at two free-standing hospitals, nine primary care clinics, multiple specialty clinics and seven rehabilitation sites. Please visit childrensMN.org.

Children's Minnesota is proud to be recognized by Modern Healthcare as one of 2023's Top Diversity Leaders. The national honor recognizes the top diverse healthcare executives and organizations influencing public policy, care delivery, and promoting diversity, equity and inclusion in their organizations and the industry.

Position Summary

The RN case manager promotes efficient and effective service delivery through enhanced communication and coordination of the patient specific plan of care. Ensures the established standard of care and expected outcomes are achieved in a timely manner while facilitating appropriate resource utilization and enhancing customer satisfaction. The case manager proactively communicates with members of the healthcare team to ensure appropriate medical necessity for patients in beds; communicates with payers and patient/family/healthcare team regarding payer information as necessary. Ensures that care moves through the episode of care in a timely and efficient manner.

License/Certification/Registration Required

• Current MN RN license.
• Current BLS certification.
• Case Management certification recommended.

Education

• BS/BA in nursing or ADN with BS/BA in relevant health care major.

Experience

• 2 years current nursing experience, pediatric preferred.

Knowledge/Skills/Abilities

• Demonstrated ability to gather data, evidence, and best practice to be able to present a cogent argument to physicians and payers related to level of care, continued stay, and plan of care progression.
• Ability to challenge respectfully and negotiate successfully for optimal patient outcomes.
• Demonstrated problem solving ability which employs anticipation, creativity, resourcefulness and sound judgment to make recommendations for change/plan based on data and clinical knowledge.
• Demonstrated ability to function as part of a team and form positive, collaborative relationships with social work, hospital staff, patients, families and post-acute providers.
• Demonstrated critical thinking skills to anticipate needs, establish priorities, meet deadlines, and effectively manage a caseload of work.
• Demonstrated experience in prioritizing and delegating work.
• Demonstrated ability to engage all staff (nurses, management, physicians and ancillary staff) to facilitate a collaborative environment.
• Demonstrated ability to coach and mentor colleagues and other disciplines.
• Proficient with computers and programs.

The posted salary represents a market competitive range based on salary survey benchmark data for similar roles in the local or national market. Annual salaries displayed are based on full-time employment (40 standard hrs per week). Annual salaries for part-time positions will be prorated based on the employee's scheduled weekly hours in relation to the full-time standard. When determining individual pay rates, we carefully consider a wide range of factors including but not limited to market indicators for the specific role, the skills, education, training, credentials and experience of the candidate, internal equity and organizational needs.

All job offers are contingent upon successful completion of an occupational health assessment, drug screen, background investigation, and compliance with the U.S. Government Form I-9, Employment Eligibility Verification.

Children's Minnesota is proud to be an equal opportunity employer whose staff is representative of its community and considers qualified applicants for open positions without regard to race, color, creed, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.