RN Care Manager

2 months ago


Evanston, Illinois, United States NorthShore University HealthSystem Full time
Job Summary

We are seeking a skilled RN Care Manager to join our team in Highland Park, IL. As a key member of our care management team, you will play a critical role in facilitating patient care across the continuum, ensuring timely and efficient care delivery and reimbursement.

Key Responsibilities
  • Facilitate payor authorization processes and ensure accurate patient type assignment.
  • Collaborate with the CDI team to ensure accurate documentation of patient severity and service intensity.
  • Work with physicians, nursing, and other care team members to effect timely patient progression.
  • Identify and resolve system problems impeding diagnostic or treatment progress.
  • Monitor patient progress, intervening as necessary to ensure high-quality, efficient, and cost-effective care.
Requirements
  • Bachelor's degree in Nursing from an NLN-accredited school.
  • Minimum 2 years of clinical nursing experience, with preference for utilization review, discharge planning, case management, or disease management experience.
  • Knowledge of InterQual or MCG criteria is preferred.
  • Clinical certification, such as case management certification, is beneficial.
What We Offer
  • Career pathways for professional growth and development.
  • Competitive medical, dental, and vision options.
  • Tuition reimbursement.
  • Free parking at designated locations.
  • Wellness program savings plan.
  • Health savings account options.
  • Retirement options with company match.
  • Paid time off.
  • Community involvement opportunities.

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