Full-Time

Nurse Care Manager

Posted on 11/20/2024

Intermountain Healthcare

Intermountain Healthcare

10,001+ employees

Intermountain Healthcare is a nonprofit health system.

Education
Healthcare

Compensation Overview

$43.98 - $63.79Hourly

Mid

Salt Lake City, UT, USA

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary
Requirements
  • Current RN license for state in which the nurse practices.
  • Three years of clinical nursing experience.
  • RNs hired or promoted into this role need to have or obtain their BSN within three years of hire or promotion.
  • Bachelor's degree in Nursing (BSN) preferred.
  • Case management Certification preferred.
  • Experience in Case management, Utilization review, and/or discharge planning preferred.
Responsibilities
  • Organizes and prioritizes daily work by assessing new, current, and discharging patient needs in area(s) of responsibility. Completes 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.
  • Maintains an active role in denial prevention. Proactively intervenes with payers to prevent inpatient denials. Performs retroactive reviews on discharged patients as assigned. Communicates any necessary information to payers to help appeal existing denials. Uses level of care criteria to justify the patient's severity of illness and intensity of service. Reviews payer requirements and government regulations to ensure safe and cost-effective healthcare.
  • Screens and coordinates the discharge planning process from patient admission to departure. Assesses patient needs, develops a discharge plan, and coordinates with internal and external services for care during and after the hospital stay.
  • Identifies patients with potential avoidable delays, extended stay, readmission, or discharge needs. Coordinates with care providers and leaders to reach optimal solutions.
  • Educates, communicates, and coordinates with multiple patient care teams to ensure the patient receives quality care, a timely discharge, and to identify and resolve delays and issues.
Intermountain Healthcare

Intermountain Healthcare

View

Company Stage

Grant

Total Funding

$1.8M

Headquarters

Salt Lake City, Utah

Founded

1975

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Simplify's Take

What believers are saying

  • Intermountain's expansion in Nevada increases healthcare access and market presence.
  • The new hospital in Billings, MT, will modernize healthcare infrastructure in the region.
  • Intermountain's research grant supports advancements in heart disorder treatments.

What critics are saying

  • Ryan Smith's transition as CDIO may disrupt ongoing digital projects.
  • The $1B hospital project in Billings could strain financial resources.
  • Scaling virtual cardiology care with Story Health may lead to inconsistent experiences.

What makes Intermountain Healthcare unique

  • Intermountain Health is a leader in digital health transformation and innovation.
  • The organization has a strong presence in the Rocky Mountain region with 33 hospitals.
  • Intermountain's partnership with Story Health enhances its cardiology care through virtual solutions.

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