Providence is calling a RN Case Manager to the Case Management and Social Services Department at Providence Alaska Medical Center in Anchorage, AK.
Under general supervision, this position uses Case Management Guiding Principles in partnering with patients and physicians to assure access, services, and transition for the continuum of care. They will work as team member with health care professionals, community resources, liaisons, and families to provide coordinated admission and discharge planning.
In this position you will:
- Perform integrated initial and concurrent review to identify medical necessity and utilization issues.
- Apply admission, continued stay/transfer, and discharge criteria to each patient's case.
- Interface with external review companies and consultants, using advocacy and negotiating skills that address medical necessity and appropriateness of inpatient/outpatient levels of care.
- Advocate and support the case management process using the Patient-Centric Care Management Model as a guideline.
- Partner with the healthcare team, community resources, liaisons, and families to provide timely coordinated admission and discharge planning that is appropriate based on patient needs.
- Match patients with appropriate internal and external resources to meet their ongoing needs, and facilitates application(s) for programs and referrals for special needs.
- Assist in management of resources with informational and monitoring tool(s) that support access, confidentiality, assessment, analysis of care and throughput, intervention, efficiencies, and quality of care.
Required qualifications for this position include:
- Graduate from accredited school of Nursing.
- Current Registered Nurse licensure.
- Licensed as Registered Nurse in the State of Alaska at time of hire.
- Two (2) years experience as a Registered Nurse.
Preferred qualifications for this position include:
- Bachelors of Science in Nursing (BSN.)
- Three (3) years of clinical nursing experience.
- One (1) year of experience as an RN in Utilization Management-review, Case Management and Discharge-planning experience.
- Prior experience with provider requirements for admissions, transfers and discharges.
- Experience with InterQual criteria, Medicare standards and COBRA regulations.
- Prior experience using Electronic Medical Records (EMR) such as EPIC.
- Prior experience using Microsoft Office Suite.
About Case Management
Our dedicated team of Nurse Case Manager's and Social Work professionals work in close collaboration with healthcare team members and providers to assist neonates to geriatric patients and families in making decisions regarding continuity of care. Our team's scope of practice includes utilization review to determine medical necessity and level of care needs.
About Providence Alaska Medical Center
Providence Health & Services Alaska is among nation's best employers for healthy lifestyles! The National Business Group on Health, a non-profit association of large U.S. employers, has honored Providence Alaska for its commitment and dedication to promoting a healthy workplace and encouraging our caregivers (employees) and families to support and maintain healthy lifestyles. Mountain-Pacific Quality Health has awarded Providence Alaska Medical Center with its Quality Achievement Award for high-quality care in the areas of heart attack, heart failure, pneumonia and surgical infection prevention. This is the highest honor awarded by Mountain-Pacific.
As the state's largest hospital, Providence Alaska Medical Center provides full-service, comprehensive care to all Alaskans, a role unmatched by any other in the state. Within our community, you will find top notch ski resorts, kayaking, and wildlife. Enjoying the outdoors is just one of many reasons to live in and explore Alaska!
We offer a full comprehensive range of benefits - see our website for details
As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.
Providence Health & Services is the third largest not-for-profit health system in the United States. Providence employs more than 82,000 caregivers (employees) across a five-state area; AK, WA, MT, OR, and CA. Our facilities include 34 hospitals, 600 physician clinics, senior services, supportive housing and other health and educational services. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Administrative Support (Clinical)
Req ID: 151735