Rn Care Manager Ne

Position Highlights:

• Sign on bonus: (if applicable)
• Position: RN Care Navigator
• Location: Highland Park
• Full Time: 40 hours, Day
• Hours: Monday-Friday, [hours and flexible work schedules]
• Required Travel: Yes

What you will need:

• License: Current professional Nursing Licensure in the state of IL required
• Education: Bachelor's degree required. Bachelor's degree in Nursing from a NLN accredited school of nursing is preferred.
• Certification: Clinical certification, such as case management certification, is beneficial. Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer (American Red Cross).
• Experience: Minimum of 2 years clinical nursing experience required; Previous experience in Utilization Management, Managed Care or chronic disease management highly preferred. Experience with Electronic Medical Record (EMR) platform preferred. Knowledge of InterQual or MCG criteria is preferred.

What you will do:

• Facilitates payor authorization processes and ensures that the patient type assigned is accurate.
• Facilitates the collaborative management of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement.
• Works with the CDI team to ensure that documentation accurately reflects severity of illness and intensity of service.
• Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient progression.
• Addresses/resolves system problems impeding diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge so that length of stay is optimized.
• Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
• Monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective.

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

NorthShore - Edward-Elmhurst Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. Located in Naperville, Linden Oaks Behavioral Health, provides for the mental health needs of area residents. For more information, visit NorthShore.org, SwedishCovenant.org, NCH.org and EEHealth.org.
When you work for NorthShore - Edward-Elmhurst Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website (www.northshore.org) to better understand how
NorthShore - Edward-Elmhurst Health delivers on its mission to "help everyone in our communities be their best".
NorthShore - Edward-Elmhurst Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor