RN Case Manager

Overview

Come join our growing Case Management Team! Utilize your clinical & critical thinking skills to coordinate care from hospital to next level of care. This position is supported by highly skilled departmental administrative staff and interacts collaboratively with the patient as well as resources internally and externally to deliver high quality care.

• This position provides clinical case management services aimed at enhancing patient-centered care and maximizing outcomes across the patient care continuum from pre-admission through post-discharge.
• Case management services include monitoring patient care to ensure progress toward desired outcome, addressing patient and family needs, resolving obstacles to effective care, coordinating care with payers and vendors, patients and families.
• Together with multiple other internal team members, the case manager is responsible for establishing, monitoring and executing patients discharge plan.
• This position may be required to access and administer medications within their scope of practice and according to State Law.

• Pro-rated benefits based on FTE:
  Health Coverage, Dental Coverage, Life Insurance, Retirement, Paid Time Off, 11 Paid Holidays per year

• Knowledge / Skills / Abilities:
  Ability to perform the essential functions of the job; ability to work variable and rotating shifts; demonstrated leadership, critical analysis, and strong communication skills; knowledge of funding resources and clinical standards/outcomes; ability to provide care for the population served; independent judgment to assess and meet client needs; ability to assess data and provide care per department policies; demonstrates lifespan development knowledge.
• Two years of professional experience in a clinically related area.
• Dependent upon the department of hire, may be required to provide reliable transportation for site visits.
• Licenses
  
  Required:
  
  One of the following licenses (or equivalent per department needs):
  Registered Nurse (Utah) or Interstate Compact license, Licensed Clinical Social Worker (LCSW) in Utah, Clinical Mental Health Counselor in Utah, Physical Therapist in Utah (PT Compact), Occupational Therapist in Utah, or other as determined by the hiring department.
• Preferred:
  Basic Life Support for Health Care Providers (American Heart Association);
  Certified Case Management designation; prior experience in clinical resource management and third-party payer interactions.

• Coordinate the case management process from patient entry to post-discharge, including outpatient settings; collaborate with physicians, social workers, and other team members to optimize outcomes.
• Identify patients suitable for case management intervention based on cost, complexity, frequency of admission, and stakeholder requests.
• Monitor and document quality of care; assess client and family response; measure care plan effectiveness and address ethical and cultural needs.
• Determine appropriate level of care using diagnosis, severity, required services, and standards; discuss funding and insurance issues to promote cost-effective utilization.
• Negotiate with third-party payers regarding benefits, eligibility, utilization review, and reimbursement.
• Identify and communicate delays in service or treatment to the health care team; plan timely discharges with the team.
• Establish measurable discharge planning and self-management goals; oversee CMS Important Message issuance to patients.
• May supervise technical support staff and may set up follow-up appointments or perform post-discharge calls; may conduct home or site visits as required.
• Support rotating schedules including nights, weekends, and holidays as needed to meet 24/7 patient care demands; maintain regular, reliable attendance.

Employee must meet requirements with or without accommodation. This position involves light work and may involve lifting up to 20 pounds; may require travel to patient care settings. The role does not provide direct patient care. Workers may be exposed to infectious diseases and may work around prisoners or behavioral health patients. Physical capabilities include various movements as listed in job data.

EO/AA statements and institutional information are referenced in company materials. The University of Utah Health is a Level 1 Trauma Center with a network of hospitals and clinics dedicated to patient care, research, and education.