RN Case Manager- Riley Children's Hospital
Job Location
Department
30 June, 2023
Full Time
Day
353118
RN Case Manager- Riley Children's Hospital
This job posting is no longer active.
Job Description
Overview
We are Indiana’s largest and most skilled pediatric system, with over 50 locations across the state. As one of the nation’s leading healthcare networks specifically for children, our multidisciplinary team of pediatric primary care and specialists can deliver and coordinate healthcare for every child because we have expertise in all areas of pediatric health.
This position is part of the Integrated Care Management department that includes MSW Social Workers and CM Consultants. This model allows the RN Case Manager to work in conjunction with their social work counterpart to work an effective discharge plan, while the consultant provides support to both disciplines.
One day a week remote offered with minimal after hours or weekend coverage.
The pediatric case manager plan is a unique and exciting opportunity to coordinate care for patients from admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures patients are assigned the appropriate level of care, receives the necessary services, and transitioned to the appropriate level of care post-discharge. Performs accurate, timely and effective discharge planning for patients. Works with payers and/or IU Health revenue cycle to ensure coverage. Provides education and support to patients/caregivers.
• Requires current state of Indiana license as a Registered Nurse.
• Certification in Case Management preferred.
• Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
• Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
• Ability to comprehend third party contractual arrangements is preferred.
• Understanding of the third party denial and appeal process is preferred.
• Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
• 3-5 years of experience required.
• Requires strong clinical background in acute care.
#LI-SL1
We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
Qualifications for the RN Case Manager- Riley Children's Hospital Role
Overview
We are Indiana’s largest and most skilled pediatric system, with over 50 locations across the state. As one of the nation’s leading healthcare networks specifically for children, our multidisciplinary team of pediatric primary care and specialists can deliver and coordinate healthcare for every child because we have expertise in all areas of pediatric health.
This position is part of the Integrated Care Management department that includes MSW Social Workers and CM Consultants. This model allows the RN Case Manager to work in conjunction with their social work counterpart to work an effective discharge plan, while the consultant provides support to both disciplines.
One day a week remote offered with minimal after hours or weekend coverage.
The pediatric case manager plan is a unique and exciting opportunity to coordinate care for patients from admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures patients are assigned the appropriate level of care, receives the necessary services, and transitioned to the appropriate level of care post-discharge. Performs accurate, timely and effective discharge planning for patients. Works with payers and/or IU Health revenue cycle to ensure coverage. Provides education and support to patients/caregivers.
- Associate's Degree in Nursing required. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date.
- Requires current state of Indiana license as a Registered Nurse.
- Certification in Case Management preferred.
- Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
- Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
- Ability to comprehend third party contractual arrangements is preferred.
- Understanding of the third party denial and appeal process is preferred.
- Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
- 3-5 years of experience required.
- Requires strong clinical background in acute care.
#LI-SL1
Indiana University Health is Indiana’s most comprehensive health system, with 16 hospitals and nearly 40,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We’re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.
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