Nurse Care Manager 1

Location: Chicago, IL

Hospital: RUSH University Medical Center

Department: Care Management

Work Type: Full Time (Total FTE between 0. 9 and 1. 0)

Shift: Shift 1

Work Schedule: 8 Hr

Summary:
The Nurse Care Manager 1 works with physician practices and inpatient teams to promote the effective utilization of services and coordination of care for adult, geriatric, neonate, pediatric and adolescent patients. The Nurse Care Manager 1 contributes to the team's effectiveness by reviewing plans of care, identifying barriers to effective and efficient utilization of resources, and appraising patients' psychosocial, financial and clinical needs throughout the continuum of care. The Nurse Care Manager 1 functions as a liaison between patients, physician practices, the hospital, and the community and ensures that patients' continuity of care needs are met. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Responsibilities:
1. Functions as an expert clinical practitioner within the Case Management team and serves as a resource to assigned physician practice groups. Shares their professional expertise as a nurse and serves as a resource for CMs within their team to manage clinically complex cases.
2. Assesses patients' health care needs, monitors patients' progress, and confers with physician practice group and health care team regarding variances from the anticipated plan of care.
3. Provides basic assessment of patient's psychosocial, financial, cultural, and family situation. Coordinates social services for patients and families to address needs. Seeks assistance as needed regarding in-depth psychosocial needs.
4. Manages a complex patient caseload and demonstrates expert ability to coordinate and implement discharge management services and provide continuity of care planning. Finds community resources for potential sources of assistance, maintains contact with community resources, and consults with physicians and inpatient groups regarding use of community resources
5. Reviews admissions and ongoing stays of patients with respect to the medical necessity, appropriateness, and quality of care. Applies criteria, performs concurrent review process. Works with physicians and Medical Director regarding Case issues and concurrent denials an indicated.
6. Applies pathways/guidelines, assesses variances, and proposes interventions as indicated. Participates in the development, implementations and evaluation of pathways/guidelines and process improvement plans.
7. Collaborates with inpatient staff and physician groups to determine goals for length of stay management and discharge management activities. Promotes cost-effective quality care services
8. Monitors and reports potential quality issues and makes recommendations when appropriate.
9. Utilizes the CM information system and appropriate technologies. Monitors variances and trends related to select goals. Assist CM team and hospital groups to develop action plans and address identified opportunities for improvement.
10. Promotes customer satisfaction among patients, families, physicians, external case managers, payers, vendors, and inpatient staff. Actively promotes ICARE principles.
11. Performs basic administrative tasks related to job: - e.g. time planning, recording reports and other routines as requested. Provides training, supervision, and orientation for staff and new employees as needed. Makes professional judgements with minimal administrative supervision. Maintains professional growth by attendance at various department, institutional, and external meetings, seminars, and workshops.

Other information:
Required Job Qualifications:
Current license in Illinois as Registered Nurse (RN).
Ability to perform all job components and serve as a team resource for clinically complex cases within their professional expertise.
Bachelors in Nursing from an accredited university or comparable educational preparation.
Two years' experience as a health care provider for the neonate, pediatric, adolescent, adult and /or geriatric patient, and expert knowledge in case management, discharge planning, social service, and criteria application.
Ability to perform tasks independently, prioritize workload, and analyze data.
Experience with information system and windows technology and competency within the CM Information System.
Team building skills and flexibility is crucial.
Physical Demands:
Ability to travel throughout the Medical Center.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.