Job Description:

The Nurse Care Manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs. The position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication, coordinates services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. This position manages complex specialty areas of care and acts in a mentoring/leader capacity to other care managers.

Job Specifics

• Pay Range: $43.98 - $63.79 Exempt
• Benefits Eligible: Yes
• FTE: Full time
• Shift: 40hrs a week
• To learn about additional Intermountain benefits: Click here

Job Essentials

• Identifies patient populations using specific screening criteria, medical record review or through referrals for service per department policy/guidelines includes trigger list, timeframes for assessing patient, and pre-screen criteria.
• Assessment completion includes: Reviews of medical records, focused reports and/or referral information to gather relevant data per department guidelines. Obtains additional necessary information by interviewing the patient/family/significant other (SO). Assesses patient/member per CMS Condition of Participation (COP) or National Clinical Quality Association (NCQA) standards. Ensures a plan of care is developed and maintained for members receiving care management services consistent with COP/NCQA and department standards. Develops plan of care using established evidence-based care process models or care plans.
• Coordinates and facilitates communication among the member/caregivers /representative, members of the healthcare team, and other relevant parties (e.g. referral physicians, community organizations, post-acute providers, other payers, Sales Team, Employer Groups, etc.). Coordinates with appropriate individuals to help ensure consults, testing, procedures are sequenced in a manner that is appropriate to patient clinical condition and supports timely and efficient care delivery. Care Management actively intervenes and resolves/escalates where barriers to service exist across the care continuum. Monitors patients through Care Coordination Rounds, patient contacts. Sets specific follow-up schedule with member following department guidelines. Works in a mentoring capacity with the Care Manager I's to assess appropriate level of care and develop alternative care to offset the disparity between plan design and treatment needed. Trains on and may handle more complex problem, questions and clinical circumstances. Works in collaboration with the department educator to foster an instructive and guiding atmosphere for Care Manager I's. Provides an expert level of support for Care Manager I's as needed. Other Clinical duties as assigned.

Minimum Qualifications

• Bachelor's degree in Nursing (BSN) from an accredited institution (degree will be verified).
• Current RN license in state of practice.
• Three years of clinical care management experience.
• Basic computer skills and knowledge of word processing and spreadsheet software.
• Intermediate knowledge of work processing and excel software.
• Strong written and verbal communication skills.
• Demonstrated ability to exercise critical thinking skills.

Preferred Qualifications

• Case Management Certification or must be achieved within 24 months of hire or transition into position.
• Experience working in clinical care management or with third party payers.
• Knowledge of care management.
• Knowledge of health insurance related products.
• Working understanding of coding, episode of care and length of stay guidelines.
• Written and verbal communication skills.
• Ability to work independently, be self-motivated, have a positive attitude, and be flexible in a rapidly changing environment.

Physical Requirements:

• Physical Requirements
• Interact with others requiring the employee to communicate information.
• Operate computers and other office equipment requiring the ability to move fingers and hands.
• See and read computer monitors and documents.
• Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.

Location:

World Trade Center

Work City:

Salt Lake City

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$43.98 - $63.79

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.