Intermountain Healthcare Nurse Care Manager - Registered Nurse (RN) - Hospital Care Management in Spanish Fork, Utah
The Nurse Case Manager utilizes clinical expertise and critical thinking skills to develop and implement a plan of care that provides cost effective, extraordinary care. This position works collaboratively with patients, patient families/significant others, healthcare providers, insurers, community resources, and other involved parties.
Organizes and prioritizes daily work by assessing new, current, and discharging patient needs in area(s) of responsibility. Completes documentation as required.
Performs utilization review activities to provide patient appropriate, timely, and cost effective care. Coordinates care with patient, care providers, hospital financial services, and third-party payers.
Maintains an active role in denial prevention. Proactively intervenes with payers to prevent inpatient denials. Performs retroactive reviews on discharged patients as assigned. Communicates any necessary information to payers to help appeal existing denials. Uses level of care criteria to justify the patient's severity of illness and intensity of service. Reviews payer requirements and government regulations to ensure safe and cost-effective healthcare.
Screens and coordinates the discharge planning process from patient admission to departure. Assesses patient needs, develops a discharge plan, and coordinates with internal and external services for care during and after the hospital stay
Identifies patients with potential avoidable delays, extended stay, readmission, or discharge needs. Coordinates with care providers and leaders to reach optimal solutions.
Educates, communicates, and coordinates with multiple patient care teams to ensure the patient receives quality care, a timely discharge, and to identify and resolve delays and issues.
Benefits Eligible: No
Shift Details: On-Call/PRN- 0 guaranteed hours.
Department/Unit: Hospital Care Management
Bachelor's degree in Nursing (BSN). Education must be obtained from an accredited institution. Degree will be verified.
Current RN license for state in which the nurse practices.
Three years of clinical nursing experience.
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Basic computer skills and knowledge of word processing software.
Case management Certification.
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experience in Case management, Utilization review, and/or discharge planning.
Experience in Case management, Utilization review, and/or discharge planning.
Additional Job DescriptionOngoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess patient needs.
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Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
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Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information, etc.
Spanish Fork Hospital, Utah Valley Hospital
Scheduled Weekly Hours:
Being a part of Intermountain Healthcare means joining a world-class team of over 38,000 employees and caregivers while embarking on a career filled with opportunities, strength, innovation, and fulfillment. Our mission is: Helping people live the healthiest lives possible.
Our patients deserve the best in healthcare, and we deliver.
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Equal Opportunity Employer
Intermountain Healthcare is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.
All positions subject to close without notice. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability or protected veteran status. Women, minorities, individuals with disabilities, and veterans are encouraged to apply.
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