Clinical Case Manager
4 weeks ago
Job Title: Clinical Case Manager
Department: County Care - Health Plan Services
Location: John H. Stroger Hospital
Shift: 8:30 AM - 4:30 PM
Job Summary:
We are seeking a skilled Clinical Case Manager to join our team at Cook County Health and Hospitals System. As a Clinical Case Manager, you will play a critical role in supporting effective and efficient inpatient care while acknowledging patient/family preferences, treatment requirements, and self-care capabilities to determine and appropriate discharge plan.
Responsibilities:
- Performs an admission review that includes assessing patient status, determining whether the patient's condition meets medical necessity criteria for inpatient care, and identifying significant discharge barriers.
- Validates pay source and physician orders as necessary.
- Collaborates with social work colleagues to determine the approach to discharge planning and which discipline is most appropriate to lead.
- Reassesses patient as clinically indicated or required by payer.
- Documents authorizations and case notes according to departmental policy.
- Presents concise, comprehensive reviews of assigned patients during rounding.
- Identifies concerns regarding quality and risks, reporting them to the supervisor.
- Interacts with physicians regarding medical necessity, identification of appropriate discharge, disposition, reasonable alternatives, or information necessary to support discharge planning.
- Participates in Quality Improvement (QI) activities, pilots, workgroups, and other activities to improve departmental operations.
Requirements:
- Registered Professional Nurse in the State of Illinois.
- Three (3) years of experience as a Registered Professional Nurse in inpatient care, home care, ED, or patient-centered medical home.
- Preferred Qualifications: Bachelors of Science in Nursing from an accredited institution, previous experience with administering medical necessity criteria, previous care management experience for patients with multiple chronic disease and acute illness, Accredited Case Manager (ACM) or Certified Case Manager (CCM), bilingual skills in either English/Spanish or English/Polish.
Benefits:
- Medical, Dental, and Vision Coverage
- Basic Term Life Insurance
- Pension Plan and Deferred Compensation Program
- Employee Assistance Program
- Paid Holidays, Vacation, and Sick Time
- You may also qualify for the Public Service Loan Forgiveness Program (PSLF)
How to Apply:
Please submit your application, including your resume and cover letter, to our website. We are an equal opportunity employer and welcome applications from diverse candidates.
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