RN Manager - Case Management - Inpatient

Dev; Peoria (AZ); On-site; USD 100,984 - 151,549; Full time

Benefits offered by this job

Comprehensive benefit plans

Continuing education opportunities

Inclusive work culture

Job summary

A leading healthcare provider is seeking an experienced RN Manager for Care Management to oversee case managers and social workers in a collaborative environment. The candidate will resolve issues related to utilization review, lead discharge planning, and ensure compliance with regulations. A Bachelor’s degree in nursing and five years of relevant experience are required. This role offers competitive compensation and valuable benefits. A commitment to inclusivity and diversity is emphasized throughout the organization.

Qualifications

• Graduate of a Bachelor’s degree in nursing program is required.
• Five years of hospital-based case management experience.
• Knowledge of Medicare/Medicaid and other payer sources is essential.
• Strong clinical nursing practice in adult medical/surgical/ICU areas is required.

Responsibilities

• Provide leadership for case managers and social workers.
• Resolve utilization review and denial management issues.
• Collaborate to maximize patient flow and mitigate reimbursement issues.

Skills

Clinical nursing practice

Excellent communication skills

Inpatient utilization review knowledge

Flexibility

Innovative

Education

Bachelor’s degree in nursing (BSN)

Master’s degree (preferred)

Job description

Full-time

Company Description

Jobs for Humanity is partnering with Mayo Clinic to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located.

Company Name: Mayo Clinic

Job Description

Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans to take care of you and your family, now and in the future. With continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting diversity, equity and inclusion, and provides the resources you need to succeed.

Responsibilities

The RN Manager, Care Management provides leadership, direction, and resource management for case managers and social workers in the inpatient and ambulatory settings. The RN Manager resolves utilization review and denial management issues, provides leadership in resolving psychosocial issues, and removes barriers for case managers and social workers to facilitate safe discharge planning. The RN Manager collaborates internally and externally to maximize patient flow and mitigate reimbursement issues. Internal collaboration includes pre-certification staff, admitting and billing office personnel, contracting staff, house supervisors, risk management, physicians, and specialty departments that impact needs during the inpatient stay and through discharge. External collaboration includes health plans, providers, and vendors. The individual has strong working knowledge of Medicare/Medicaid, regulatory compliance mandates, auditing agencies, NCDs and LCDs, and understands and applies utilization management standards from entry through discharge. The RN Manager assists in developing and owning the department's vision and planning, fostering teamwork and an open creative environment for staff. The RN Manager coordinates, implements, and evaluates staff development and manages staff performance proactively. The RN Manager supports staff leadership activities, including community involvement and participation in committees and research. This individual must demonstrate knowledge of growth and development of the life span and interpret information relative to the patient’s needs.

The RN Manager, Care Management supports leadership amongst the staff through activities that include staff development, community involvement, and participation in committees and research. The American Nurses Association (ANA) Nursing Scope and Standards of Practice, the ANA Code of Ethics for Nurses, and the Commission for Case Manager Guideline provide the basis for practice.

This role is eligible for TN sponsorship. Holders of F1 status eligible for post-completion OPT are welcome to apply. This role is NOT eligible to participate in the F-1 STEM OPT extension program. Successful sponsorship will require state licensure and completion of the VisaScreen or equivalent certification.

Qualifications

Qualifications:

• Graduate of a Bachelor’s degree in nursing program (BSN Required).
• Five years of hospital-based case management, including discharge planning and utilization review experience.
• Knowledge of Medicare/Medicaid and other payer sources, benefits, and limitations.
• Strong inpatient utilization review knowledge related to status and process.
• Demonstrated strong clinical nursing practice in adult medical/surgical/ICU areas.
• Must be highly motivated, flexible, innovative, and self-directed.
• Excellent communication and interpersonal skills and proficiency with computers.
• Preferred Education: Master’s degree. Preferred Experience: Five years of supervisory/management experience in an inpatient medical setting. Preferred working knowledge of Interqual Criteria and MIDAS

License and Certifications:

• Current RN licensure from Arizona.

Exemption Status

Exempt

Compensation Detail

$100,984 - $151,549 / year

Benefits Eligible

Yes

Schedule

Full Time

Hours/Pay Period

80

Schedule Details

Monday - Friday 0800-1700. May require 0700 meetings and as late as 1700 meetings. If needed, may need to assist with staffing by taking an assignment. Available to staff on a rotational basis to answer questions on off hours.

Weekend Schedule

Available on a rotational basis to answer questions on off hours including weekends.

International Assignment

No

Site Description

Our Mayo Clinic locations include Phoenix/Scottsdale, AZ; Jacksonville, FL; Rochester, MN; Mayo Clinic Health System campuses in Midwestern communities; and international locations. Each Mayo Clinic location is a place where employees thrive in both work and personal life.

Affirmative Action and Equal Opportunity Employer

Mayo Clinic is committed to creating an inclusive environment that values diversity and does not discriminate. Women, minorities, veterans, LGBTQ individuals, and people with disabilities are encouraged to apply. Reasonable accommodations to access job openings or apply are available.

Recruiter

Danelle White