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Care Manager - Outpatient (RN)

Req #:  115505
Facility:  Advocate Medical Group
Department:  Nursing
City:  Evergreen Park
Posting Budget Status:  Day
Shift Type:  Full Time - Permanent
Posting FTE:  1

Position Requirements:
RN with 4~5yrs of clinical experience.
1~2yrs of which in IPA, PHO, or HMO setting performing UM case management or referral authorization. competent Computer navigation skills
Ability to demonstrate excellent oral, written and interpersonal skills.
Good organizational skills.
Strong interpersonal skills.
Ability to handle multiple responsibilities.
Knowledgeable in CQI principles. Critical thinking skills and ability to analyze complex data sets required Active licensed RN Ability to work independently. Local travel. Ability to handle stress and high work load volumes. Flexible with work hours, including early evening until 8pm, saturdays, on~call

If position has direct patient care or direct patient contact the following lifting requirement supersedes any previous lifting requirement effective 06/01/2015. Ability to lift up to 35 pounds without assistance. For patient lifts of over 35 pounds, or when patient is unable to assist with the lift, patient handling equipment is expected to be used, with at least one other associate, when available. Unique patient lifting/movement situations will be assessed on a case~by~case basis.

Purpose:
Performs timely coordination of quality healthcare services to meet an individual's specific healthcare needs in a cost effective manner to promote positive outcomes. The RN Outpatient Care Manager works in conjunction with the assigned patient's Advocate primary care and specialty physician(s) to implement care coordination activities that support the physician's treatment plan. The RN Care Manager's caseload includes, but is not limited to high risk patients identified by physician(s), Decision Support tools,referrals,claims.

Accountabilities:
The Outpatient Care Manager serves in an expanded clinical role to operate in collaboration with patients' primary care team/office and collaborate with hospital care managers, post acute care managers, and other care partners to provide a model of care that ensures the delivery of quality, efficient, and cost~effective healthcare services. May work embedded within an APP/AMG PCP or OB/specialist practice, or telephonically working with a care team.
Independently manages timely completion of activities on work list and file documentation to ensure all necessary MCO and regulatory timeframe and content requirements are met. Maintains the appropriate number of cases, based on department expectations.
Understands and contributes to the department's defined AdvocateCare measures and department KRAs
Effective communication with internal and external customers and care providers in a positive and professional fashion in order to promote patient/provider satisfaction, quality of care delivered and an increased awareness of appropriate utilization. Customers include but not limited to: External: primary care office team, inpatient care managers, hospitalists, specialists, community agencies and providers, employers Internal: Department medical directors, director, case management services, manager, case management, supervisor, case managers, referral technicians, care continuum team members, peers


Addendum:
Reflect that the position reports to a supervisor, tweek other verbiage to account for various roles within CM dept. that still function within this JD.


Nearest Major Market: Chicago