Responsible for managing and coordinating the patient care transitions program. This ensures the patient's progression through the care continuum in a manner that achieves designed clinical and financial outcomes. Participates in the system development and implementation of integration of care transitions along the continuum of care. Works in close collaboration with the multidisciplinary team, in all settings to include ambulatory, post - acute providers and health plans. Serves as mentor by role modeling a professional practice consistent with organizational goals, customer service, clinical effectiveness, and standards of care. Responsible for developing and managing the departmental budget, compliance to federal, state and regulatory requirements.
Education
BSN requiredCertification/Licensure
Valid RN licenseFor Integrated Care Management departments, specialty certification is required within one year of eligibility (ACM, CCM, CCCTM, CMAC, or CGMT-BC). For other service lines, certification based on specialty area is required within one year of eligibility.Experience
3 years of Case Management RN experience required. Chronic conditions, Pregnancy, Behavioral Health, and Complex case experience preferred.MCO experience preferred.1 year Leadership experience required.keywords: LinkedIn, Nursing Acute Care, Full Time, Case Management, RN, Registered Nurse, BSN, Talroo-Nursing, Monster, care coordinator, utilization review, authorization, MCO, compliance, regulation, medical necessity, service lines, ACM, CCM, TCM, CMAC or CGMT-BC, chronic complex cases, managed care, commercial
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay rate for Full Time employment is:$87,443.20-$145,745.60. Additional compensation may be available for this role such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.