About the position
The Continuum Care Manager, RN is a vital role within Endeavor Health, responsible for providing comprehensive case management and utilization management services to patients across various clinical areas. This position is designed to ensure that patients receive the necessary support during their care transitions, particularly focusing on discharge planning. The role requires collaboration with social work and other interdisciplinary team members to identify and mitigate any gaps in care transitions. The Continuum Care Manager will engage in daily functions such as admission reviews, continued stay reviews, and liaising with insurance companies to provide clinical information that supports patient admissions and continued hospital stays. Additionally, the manager will refer cases to the Physician Advisor for further review and collect quality assurance and avoidable days data as directed. In this position, the RN will be accountable for a designated patient caseload, utilizing assessment, implementation, coordination, monitoring, and evaluation skills to effectively meet patient needs. The role emphasizes the importance of managing the length of stay and promoting efficient utilization of resources. The Continuum Care Manager will work independently, setting priorities to coordinate care plans efficiently while also being an integral member of a collaborative team. This position is full-time, requiring 36 hours per week on a night shift schedule, with rotating weekends and holidays. Required travel to float to other sites is also part of the job expectations.
Responsibilities
- Provide comprehensive case management and utilization management services to patients.
- Conduct discharge planning in collaboration with social work and interdisciplinary teams.
- Perform admission reviews and continued stay reviews for patients.
- Contact insurance companies to provide clinical information supporting admissions and continued hospital stays.
- Refer cases to the Physician Advisor for further review as needed.
- Collect quality assurance and avoidable days data as directed.
- Manage a designated patient caseload effectively to meet patient needs.
- Promote efficient utilization of resources and manage the length of stay.
Requirements
- Bachelor's degree in Nursing from an NLN accredited school of nursing is required.
- Minimum of 2 years clinical nursing experience preferred.
- At least 2 years of experience in utilization review, discharge planning, case management, or disease management preferred.
- Knowledge of InterQual or MCG criteria is preferred.
- Clinical certification, such as case management certification, is beneficial.
- Basic Life Support for Healthcare providers (AHA) or CPR/AED for the Professional Rescuer certification is required.
- Strong interpersonal and oral communication skills are necessary.
- Experience with Microsoft Office Suite is required.
- Proven leadership skills and ability to work independently are essential.
- Experience with Electronic Medical Record (EMR) platform is preferred.
Nice-to-haves
- Knowledge of community resources is beneficial.
- Strong computer and data entry skills are preferred.
Benefits
- Dental insurance
- Health insurance
- Health savings account
- Paid time off
- Retirement plan
- Tuition reimbursement
- Free parking at designated locations
- Wellness program
- Career pathways to promote professional growth and development
- Various medical, dental, and vision options
