RN Care Manager - Case Management

Description Care Manager RN - Case Management, Providence Sacred Heart Medical Center & Children's Hospital, Spokane WA Assumes accountability for the management, coordination, and facilitation of activities for a defined patient population, necessary to achieve length of stay and resource consumption outcome goals, while maintaining or improving quality of service. Functions in a leadership role as a member of a multidisciplinary team to achieve collaborative practice, coordinated care, continuity of care, consistent and/or expected clinical outcomes, efficient management, and quality improvement. Responsible for implementing the utilization review program following the HFH Utilization Management Plan and assist with quality improvement data collection. Provides leadership to staff, management, physicians and others in implementation of and compliance with Medicare/Medicaid regulations/rules/guidelines and utilization rules of third party payer contracts. Provides teaching, consultation, guidance, and advice for physician intent for admission, improved clinical documentation, and proper coding of documentation. Contributes to clinical performance improvement on units by providing direction on ways to improve efficiencies, reduce costs, receive appropriate reimbursement, meet requirements. Actively participates in CMC governance, peer review, education and support processes. Reports to Director of Case Management. Providence caregivers are not simply valued - they're invaluable. Join our team at Providence Sacred Heart Medical Center & Children's Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Shift Details: Fulltime, 40 hours per week, 8 - hour dayshift Required Qualifications: Education or experience in Case Management and/or Utilization Review/Utilization Management. Upon hire: Washington Registered Nurse License Education or experience in Case Management and/or Utilization Review/Utilization Management. 3 years Within area of practice. Previous experience preferred in case management; clinical nursing and/or utilization management. Preferred Qualifications: Bachelor's Degree Nursing. Experience in computer technology, laptops, Microsoft Office products. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Check out our benefits page for more information about our Benefits and Rewards. About the Team Providence has bee