Northwestern Medicine
Case Manager Care Coordination Full Time Days
Winfield, IL, United States · Full-time
Sponsorship not specifiedDetected 13 hours ago
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About the role
- Full time Monday-Friday 8:00-4:30 and one weekend every 5 weeks and 1-2 holidays per year.
- At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace.
Responsibilities
- Performs utilization management activities of all inpatients and observation patients by applying approved criteria. Notify physician advisor of any outlier cases.
- Partners with the nursing staff and physicians to convey accurate and timely information to post-acute care providers to encourage a smooth hand-off and create a seamless and safe discharge to the next continuum of care.
Requirements
- Bachelors of Science in Nursing (required for hires after 01/01/2011)
- One year of case management experience in an acute hospital setting
- Two years' experience in utilization review
- Prior experience in case management or insurance setting.
- If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check.
- Ensures the patient is at the most appropriate level of care for the expressed severity of illness and level of services required.
- Provides timely and thorough reviews to third party payers as requested or required.
Compensation
- Full time Monday-Friday 8:00-4:30 and one weekend every 5 weeks and 1-2 holidays per year.
Benefits
- from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees.
- Please visit our Benefits section to learn more.
- Sign-on Bonus Eligibility (if sign-on bonus offered for position): Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus.
- This patient-first approach is what sets us apart as a leader in the healthcare industry.
- As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system.
- In collaboration with the patient/family, and members of the health care team, assesses, plans, implements, and evaluates the plan of care and the patient's response to treatment.
- Collaborates with physicians and other health care team members to clarify admission status and plan of care.
- Experiences minimal denials based on lack of medical necessity.
- Partners with the care delivery team to identify proactively and coordinate any educational needs for the patient and family.
- Queries the admitting physician for additional information as needed to meet medical necessity for admission or appropriate level of care.
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This listing is sourced directly from Northwestern Medicine's careers page and normalized into a canonical job model.