Rn Care Manager

Job Description:
Position Highlights:

• Position: RN Care Manager
• Location: Chicago, IL
• Full Time
• Hours: Monday-Friday, 8:00 am -4:30pm
• Required Travel: No

What you will need:

• EPIC experience preferred
• Fluency in Spanish, Urdu, Hindi, or Arabic a plus.
• Graduate of an accredited school of nursing, Bachelor Degree in nursing
• Current license as a Registered Nurse in the State of Illinois
• Current CPR certification with the American Heart Association or American Red Cross
• Case Management or CCM certification preferred

Benefits:

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, and Vision options, including Domestic Partner Coverage
• Tuition Reimbursement
• Free Parking at designated locations
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Job Summary
The role of the Clinical Manager, Patient Navigation is to oversee the Community CARE Patient Navigation team and provide leadership and support within this team. To enhance the quality of clinical outcomes and patient satisfaction, this role supports providers, leaders, and interdisciplinary teams in coordinating clinical and social patient care. This role is responsible for coordination between the FQHC primary care setting, the Healthcare Transformation (HCT) specialists, the inpatient hospital setting and Community CARE programs, with an emphasis on supporting and coordinating transitions of care. The position is supported by Health Care Transformation Program funding of the Illinois Department of Health Care and Family Services (HFS)
Responsibilities and Essential Functions

• Oversee the Community CARE Patient Navigation Team. The Patient Navigation Team supports patients of the Healthcare Transformation program as well as patients in the ED and inpatient environments with complex SDOH and/or health literacy concerns, those with Medicaid and/or uninsured, and other patients as needed and as defined by department policy 30%
  • Manage team of Community Health Workers, including recruiting, hiring, orienting, providing continuing education and developing staff for professional growth opportunities; manage timecards, annual reviews, and all employee relation concerns
• Implement, coordinate, monitor and continually evaluate Patient Navigation workflows and processes, including a local Community Health Worker Program, with clear program goals and objectives, FTE structure, and analytics reporting for tracking outcomes 40%
  • Collaborate with other Swedish Hospital departments to maximize care coordination, smooth transitions of care, and optimal efficiency in patient navigation
  • Create and maintain culturally competent and thorough patient education materials to aid in transitions of care and improved health literacy
  • Collaborate with other Community CARE staff and leadership to create and manage future Patient Navigation initiatives
  • Maintain accurate records and metrics of Patient Navigation interventions including timely patient contacts, goal progression, and required data collection in coordination with system health equity team
  • Coordinate and/or perform Transition of Care clinical follow-up to patients post-acute and post Emergency Department visits, as appropriate
  • Participate in acute inpatient rounds and bedside patient visits, as appropriate, to maximize preparation for discharge and efficient transitions of care. Continue to support patient across the care continuum
• Provide direct culturally appropriate clinical case management, complex case management and transition of care activities for HCT Program patients, as directed by referral from HCT specialist 25%
  • Establish a documented patient centric case management plan involving all appropriate parties (patient, physician, collaborating providers, family, etc.), identify anticipated case results/outcomes, criteria for case closure, and promote communication within all parties involved
  • Provide telephonic support as dictated by patient needs and in collaboration with CHW team
  • Provide health education and coaches the patient with treatment alternatives to assist them in making informed decisions about healthcare choices
  • Assist with coordinating referrals, pre-authorizations and other health care needs, in collaboration with HCT referral coordinators
  • Assist insured and non-insured patients in sorting through their benefits, making choices, and exploring options
  • Act as a timely and proactive liaison and health advocate between health plans, patient/family, physician(s) and FQHCs
• Performs other job-related duties as assigned 5%

Minimum Work Experience

• Minimum of 3 years' experience in a community or clinical setting required, one year of utilization review or case management experience preferred.
• Ability to communicate effectively with a diverse patient population, interdisciplinary team at Swedish, the FQHCs and the Healthcare Transformation program.
• Strong computer skills required
• Managed care experience strongly preferred
• Experience working with Medicare and Medicaid preferred

Knowledge, Skills and Abilities (KSAs) [Optional]

• EPIC experience preferred
• Fluency in Spanish, Urdu, Hindi, or Arabic a plus.

Working Conditions
Environment

• Primary body position at work is sitting.Infrequent lifting, carrying or moving of information systems equipment or supplies under 50 lbs.Repetitive activities are; typing, phone use and viewing of video display devices
• Regular travel between FQHC sites and main hospital possible

Scope: People Management
Direct Reports: 4
Indirect Reports: 0
Overall Qualifications:
American Red Cross CPR - American Red Cross, Registered Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR)Bachelors Degree: Nursing (Required)