Care Manager RN Leader

4 days ago


Spokane, Washington, United States Providence St. Joseph Health Full time

Career Opportunity: We are seeking a highly skilled Care Manager RN to join our team at Providence Sacred Heart Medical Center & Children's Hospital in Spokane, WA.

About the Role: As a Care Manager RN, you will be responsible for managing, coordinating, and facilitating activities for a defined patient population. You will work in a leadership role as a member of a multidisciplinary team to achieve collaborative practice, coordinated care, continuity of care, consistent clinical outcomes, efficient management, and quality improvement.

Key Responsibilities:

  • Implement the utilization review program following the HFH Utilization Management Plan
  • Assist with quality improvement data collection
  • Provide leadership to staff, management, physicians, and others on implementation of and compliance with Medicare/Medicaid regulations/rules/guidelines and utilization rules of third-party payer contracts
  • Teach, consult, guide, and advise on physician intent for admission, improved clinical documentation, and proper coding of documentation
  • Contribute to clinical performance improvement on units by providing direction on ways to improve efficiencies, reduce costs, receive appropriate reimbursement, meet requirements

Requirements:

  • Bachelor's Degree in Nursing or related field
  • 3 years of experience in Case Management and/or Utilization Review/Utilization Management
  • Washington Registered Nurse License

Compensation and Benefits: The estimated salary range for this position is $83,000 - $120,000 per year, depending on experience. Additionally, we offer a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, paid time off, and professional development opportunities.



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