Job Details | Care Manager - Utilization Review

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Norwegian American Hospital

Location: ChicagoIL 60622 Document ID: A9163-04Y8 Posted on: 2015-04-3004/30/2015 Job Type: Regular

Job Schedule:Full-time
2015-05-30
 

Care Manager - Utilization Review

Go where change is really happening. At Norwegian American Hospital, accomplishment is defined not just by what you achieve for yourself, but also by what you achieve for your community. Every day, we feel we've truly accomplished something - that we've made a difference to our patients, to their families, and to each other.

We are a 200 bed community hospital located on the northwest side of Chicago. We are fully accredited by the Joint Commission and have a track record of continuous quality improvement. Join a hardworking and dedicated team of professionals who are proud to be contributing to improving patient care on a daily basis.

Care Manager - Utilization Review Full-time and per diem opportunities available

Norwegian American Hospital is seeking a dynamic, supportive RN for a care manager role with the organization. These roles are key to helping our patient achieve optimal transition and recovery, If you are the kind of nurse who is truly invested in supporting patients in a manner to achieve best possible outcomes and lowering the likelihood of their need for re-admission, we would like you to consider applying for this pivotal role.

General Summary of Position Responsibility:

Facilitates the timely coordination of quality health care services to meet patient specific healthcare needs in a cost effective manner to promote positive outcomes. Includes utilization management, discharge planning, and quality monitoring. Ensures payers' requirements for information, authorizations and certifications are met. Provides a communication link between all involved in the case management plan.

Specific Duties and Responsibilities:

Utilization Review:
  • Identifies payer source.
  • Facilitates communication of information to assure authorization and reimbursement/funding of patient care.
  • Ensures medical necessity and obtains authorization for continued care for patients.
  • Assists Director of Care Management in identifying case outliers and other potential denials as risk prevention strategy.
  • Assumes an active role in denial management

Communication:
  • Works with care team and family to implement care management plan.
  • Provides communication link


Job Requirements

1. Registered Nurse in state of Illinois required.

2. Graduate of an accredited program in nursing.

3. Three to five years relevant clinical experience.
4. Minimum two years of care management experience preferred.

We offer:

FREE, CONVENIENT PARKING!


Medical/Dental/Vision insurance

Domestic Partner benefits

Tuition Assistance - up to $5,000 annually

Flexible Spending Account

Voluntary Life, Critical Illness, Disability income, and Accident Insurance

Employee Assistance Program

Matching 403b Profit Sharing & Pension Plan (50% on the dollar, up to 4% of annual pay)

Norwegian American Hospital is an Equal Opportunity Employer
M/F/D/V



Keywords: Case Manager, Utilization Review, patients, patient relationships, Acute Care, ICU, ER, Emergency Room, RN, Registered Nurse, Nurse, admissions, assessment, screening, patient advocate

     
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