Intermountain Healthcare Nurse Case Manager - Full Time - American Fork Hospital in American Fork, Utah

Job ID:217515
Greater Salt Lake area

About Us

What does it mean to be a part of Intermountain Healthcare? It means that the quest for clinical excellence is not just a goal, but a given. It means building an environment where physicians and employees can deliver the best in healthcare. And it’s realizing each employee or volunteer is vital to the healing process, because we can only achieve theextraordinary together .

Being a part of Intermountain Healthcare means joining with a world-class team of over 36,000 employees and embarking on a career filled with opportunities, strength, innovation, and fulfillment. Our mission is: Helping people live the healthiest lives possible.

Our patients deserve the best in healthcare, and we deliver.

Job Description

Utilize clinical expertise and critical thinking skills to work collaboratively with patients, patient family/significant other, healthcare providers, insurers, community resources, and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.

Essential Job Duties

  • Organize and prioritize daily work by assessing new, current, and discharging patient needs in area(s) of responsibility. Complete documentation as required.
  • Performs utilization review activities to provide patient appropriate, timely, and cost effective care. Coordinates care with patient, care providers, hospital financial services, and third-party payers.
  • Maintain an active role in denial prevention. Proactively intervene with payers to prevent inpatient denials. Perform retroactive reviews on discharged patients as assigned. Communicate any necessary information to payers to help appeal existing denials. Use level of care criteria to justify the patient's severity of illness and intensity of service. Review payer requirements and government regulations to ensure safe and cost-effective healthcare.
  • Screens and coordinates the discharge planning process from patient admission to departure. Assess patient needs, develops a discharge plan, and coordinates with internal and external services for care during and after the hospital stay.

  • Identify patients with potential avoidable delays, extended stay, readmission, or discharge needs. Coordinate with care providers and leaders to reach optimal solutions.

  • Educate, communicate, and coordinate with multiple patient care teams to ensure the patient receives quality care, a timely discharge, and to identify and resolve delays and issues.

Posting Specifics

  • Entry Rate: Commensurate with experience.
  • Benefits Eligible: Yes
  • Shift Details: 40 hrs/wk; Monday through Friday. Weekday shifts are typically 8:30 am to 4:30 pm. Some weekends and holidays may be required. Shifts may vary or change as necessary.
  • Department: Hospital Care Management

Minimum Requirements

  • Bachelor's degree in Nursing (BSN) from an accredited institution (degree will be verified).
  • Current RN license for state in which the nurse practices.
  • Basic Life Support certification (BLS) for healthcare providers.
  • Three years of clinical nursing experience.
  • Basic computer skills and knowledge of word processing software.

Physical Requirements

  • Ongoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess patient needs.
  • Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
  • Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information, etc.

Preferred Requirements

  • Case management Certification.
  • Experience in Case management, Utilization review, and/or discharge planning.

Please Note

All positions subject to close without notice. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

Additional Details:

Working Hours 40

Primary Work Location American Fork Hosp

Expertise Nursing

Job Type Full Time

Location US-UT-American Fork