Nurse Case Manager

IL_LUHS Loyola University Medical Center - Melrose Park, IL

Full-time - Mid Level

Melrose Park, IL

10,001+ employees

About the position

The Nurse Case Manager at Loyola Medicine plays a crucial role in providing comprehensive care that addresses the physical, emotional, and spiritual needs of patients. This position is dedicated to ensuring quality services through effective monitoring and collaboration with healthcare professionals, while also managing insurance requirements and denials. The role offers an opportunity to grow within a supportive environment that values exceptional patient care and community service.

Responsibilities

• Monitors patient's progress across the continuum and intervenes as necessary to ensure quality services that are efficient and cost effective.
• Collaborates with admitting physician regarding appropriate level of care.
• Consults with Physician Advisor and administrative leadership as necessary to resolve barriers regarding progression of care.
• Knowledgeable of Medicare, Medicaid and 3rd party payers relative to patient care requirements.
• Responds to requested insurance reviews based on contractual obligations.
• Actively manages concurrent denials.

Requirements

• Required: Bachelor's Degree OR equivalent training acquired via work experience or education.
• Preferred: Master's Degree in Nursing.

Benefits

• Benefits from Day One
• Competitive compensation
• Career Development
• Tuition Reimbursement
• On Site Fitness Center
• Educational Stipend
• Referral rewards