RN Ambulatory Care Manager

Job Description:
The Central Market nurse care manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs. The position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication, coordinates services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management.
Job Specifics
Application Requirements: Please upload a current resume that includes your work history and relevant licenses or certifications.
Benefits Eligible: Yes
FTE: Full time
Click learn about additional Intermountain benefits
Location: Salt Lake Clinic
Job Essentials
Identifies patient populations using specific screening criteria, medical record review or through referrals for service per department policy/guidelines includes trigger list, timeframes for assessing patient, and pre-screen criteria. Review of medical records, focused reports and/or referral information to gather relevant data per department guidelines. Obtains additional necessary information by interviewing the patient/family/significant other (SO). Assesses patient/member per CMS Condition of Participation (COP) or National Clinical Quality Association (NCQA) standards. Ensures a plan of care is developed and maintained for members receiving care management services consistent with COP/NCQA and department standards. Develops plan of care using established evidence-based care process models or care plans. Incorporates the member's individualized needs and goals during the episode of care and within the benefit plan throughout the care management process.
Coordinates and facilitates communication among the member/caregivers /representative, members of the healthcare team, and other relevant parties (e.g. referral physicians, community organizations, post-acute providers, other payers, Sales Team, Employer Groups, etc.). Care Management will actively intervene and resolve/escalate where barriers to service exist across the care continuum. Maintains a current knowledge of community resources. Where necessary performs cost benefit analysis and coordinates. Other clinical duties as assigned.
Minimum Qualifications
RNs hired or promoted into this role need to have or obtain their BSN within three years of hire or promotion.
Current RN license in state of practice.
Two years of clinical nursing experience.
Preferred Qualifications
Bachelor's degree in Nursing (BSN) from an accredited institution (degree will be verified).
Case Management Certification.
Experience working in clinical care management or with third party payers.Knowledge of care management.
Knowledge of health insurance related products.
Working understanding of coding, episode of care and length of stay guidelines.
Written and verbal communication skills.
Interact with others requiring the employee to communicate information.
Operate computers and other office equipment requiring the ability to move fingers and hands.
See and read computer monitors and documents.
Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
Location:
Salt Lake Clinic
Work City:
Salt Lake City
Work State:
Utah
Scheduled Weekly Hours:
40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$45.31 - $67.01
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits package here.
By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
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