RN Case Manager - North Shore Medical Center

We are North Shore Medical Center. Our primary function is to offer continuous nursing, medical, and other health and social services on a 24-hour basis, under physician directed care and RN supervision.

We service a multitude of patients and their families across our vast network, while remaining committed to the professional development of our staff, the functional improvement of our patients, and the cultivation of strong partnerships within our communities.

WHAT WE OFFER

• Essential/stable and growing company with many opportunities for training and advancement within the medical field that all employees and team members (including Full-Time and Part-Time) can benefit from.
• Hourly pay is negotiable based on experience. We offer competitive market pay and opportunities for bonus depending on great work performance (bonuses only apply for Full Time).
• Comprehensive Employee Benefits: Full-Time employees are eligible for various plans for medical, dental, and vision insurance.

Position Summary

The individual's responsibilities will include, but not be limited to the following activities: a) medical necessity screening b) care coordination c) discharge planning d) facilitating multi-disciplinary patient care conferences e) managing concurrent disputes f) making the appropriate referrals to other departments (e.g., nutrition, PT/OT/ST) g ) referring complex social issues to Social Service ) communicating with patients and their families about the plan of care i) collaborating with physicians, office staff and ancillary departments (e.g., lab, pharmacy) j) participating in weekly Complex Case Review k) arranging for post -discharge patient education l) clear, complete and concise documentation in ECCM m ) maintaining accuracy of patient demographic and insurance information n) identifying and documenting potentially avoidable days o) identifying and reporting over and under utilization o) and other duties as assigned.

The individual in this position has overall responsibility for overseeing the clinical plan of care to conform to evidence-based practice and regulatory requirements. This position integrates care coordination, utilization management, and discharge planning.

• Coordinates the overall discharge planning and social services function ensuring compliance with federal and state laws and Joint Commission.
• Accepts client referrals and responds accordingly.
• Assists patients, their families, and physicians with post hospital placement.
• Maintains professional rapport with physicians, co-workers, representatives of other organizations, and departments.
• Identifies appropriate cases rendering referrals to Child Protective Services or Adult Protective Services that fulfill the legal requirements for state reporting.
• Interprets rules and regulations set by the Joint Commission, Illinois Health Department and other outside agencies.
• Demonstrates creativity, intelligence, and discretion in the planning, organizing and coordination of departmental functions.
• Provides accurate and timely information using discretion and protects confidentiality of source.
• Maintains a cost-conscious attitude to time usage, materials and supplies.
• Participates in Patient Care Conference Meetings.
• Maintains and files appropriate records.
• Establishes and maintains criteria or identifies resolutions of problems associated with utilization Review functions for the committee.
• Maintains a liaison with community agencies offering services to discharged patients.
• Maintains and files appropriate records.
• Assesses each situation and alternatives, chooses the appropriate course of action with few errors. Utilizes policy manuals and other reference materials to ensure proper course of action.
• Deliberately does not allow personal conflicts to interfere with work performance.

EDUCATION/EXPERIENCE

• Graduate of accredited school of nursing.
• Minimum five (5) years' experience in an acute care or community health care setting.
• Required qualifications should include a) R.N. (minimum of B.S.N. preferred) with at least 5 year's bedside experience or a LPN/LVN with 10 years in the relevant clinical specialty