RN Case Manager

RN Case Manager Position Summary:The RN Case Manager functions as a resource and advocate on behalf of the patient and family while assisting in the navigation of the health care delivery continuum by operationalizing multiple processes. Coordinates hospital transitions to the next level of care, including, but not limited to, medical community partners, Kootenai Care Network, and ambulatory clinic care coordinators. Responsibilities: Participates in utilization management, discharge planning, patient throughput, and evaluates the appropriate use of hospital resources by ensuring that patients meet medical necessity during their hospitalizationUtilizes the organizational approved references and software programs to assess medical necessityResponsible for managing payer relations and requirements to achieve optimum reimbursement and patient outcomesReviews documentation for quality assurance and clinical validationEnsures CMS discharge standards are achievedProvides case management in collaboration with the medical staff, nursing, and ancillary departments throughout the hospital to ensure a safe, timely, transition to the appropriate level of careRelies on experience and judgment to plan and accomplish goalsPerforms other related duties as assignedFamiliar with standard concepts, practices, and procedures within the fieldCompetent to meet age specific needs of the unit assignedRegular and predictable attendance is an essential job function Requirements and Minimum Qualifications: State of Idaho Registered Nurse or licensure pending as documented by temporary licensure OR current RN licensure from a state participating in the "multistate privilege to practice" compact with IdahoLicensed RN with a minimum 3 years' patient-facing RN experience at time of hire, ADN or diploma required; BSN or higher preferred.Licensed RN's with less than 3 years' patient-facing RN experience as an ADN at time of hire are required to be enrolled in a baccalaureate (or higher) degree program in nursing within 1 year of employment, with BSN completion within 3 years of hireMinimum 3 years clinical practice experience requiredPrevious utilization review experience preferredCurrent Certified Case Manager (CCM) certification, American Case Management (ACMA) certification, Certified Professional Utilization Review (CPUR) or Case Management Administration Certification (CMAC) preferredExcellent communication, organizational and interpersonal skills. Ability to work independently and manage time and decisionsProficiency with standard software applications including spreadsheets and word processing required. Experience using Interqual preferredKnowledge of healthcare law and regulations related to acute care and the immediate post-acute continuum preferredAbout Kootenai Health:Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider.As your next employer, we are excited to offer you:Full-time and part-time employees pay only a small portion a month for medical, dental, and vision coverage. Benefits start 1st of the month following 30 days of employmentKootenai Health's tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for itKootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3-6 percent. Competitive salaries with night, weekend, and PRN shift differentialsAn award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching Employees receive discounts at The Wellness Bar, PEAK Fitness, and moreRobust and interactive employee referral programAnd much moreKootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you! Apply today! Please reach out to Julie Pickup, 208-625-4136 or email at JPickup@kh.org. You can also contact the HR Front Desk at 208-625-4620 or email careers@kh.org with any questions. Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.