- Comprehensively assess patients' goals as well as their biophysical, psychosocial, environmental, economic/financial, and discharge planning needs.
- Procures services and resources for identified patients and families, serving as an advocate to promote achievement of agreed-upon goals.
- Advocates for the patient, family, physician, and facility to obtain benefits from insurance carriers and others that provide financial assistance for patients and promote health care treatment goals.
- Identifies and reports cases and problems appropriate for secondary review to Case Management Department leadership, the Medical Director, or Physician Advisor.
- Assesses the appropriateness and timeliness of level of care, diagnostic testing and clinical procedures, quality and clinical risk issues, and documentation completeness.
- Maintains and documents third-party payers' authorizations, contacts, and transactions for individual patients.
- Seeks out information and resources and uses creative problem solving for complex discharge planning, quality of care, and utilization issues. Explores new resources when the opportunities for the patient are absent or in short supply.
- Continually evaluates case management services and client outcomes.
- Studies information available to remain informed of reimbursement modalities, community resources, review systems, and clinical and legal issues that affect patients and providers of care.
- Serves as a resource and provides education to patients, physicians, and professional staff on levels of care, quality-of-care issues, and regulatory concerns.
- Provides orientation and mentoring to new staff.
- Works in accordance with applicable state and federal laws and with the unique requirements of reimbursement systems.
- Is knowledgeable about and acts in accordance with laws and procedures regarding patient confidentiality and release of information, Americans with Disabilities Act, other laws protecting rights, and worker's compensation laws when applicable to the case manager's practice.
- Performs other duties requested by the department leadership.
- Bachelor's Degree in Graduate of an accredited Bachelors Nursing degree program or completion of an accredited Nursing program with a Bachelors degree or higher in a health care field Or
- Applicants without a BSN degree must actively pursue and attain a BSN within three years of hire. Continued employment by Swedish beyond three years is contingent upon attaining the BSN degree
- Upon hire: Washington Registered Nurse License
- 3 years Registered nursing experience in an acute care hospital
- 1 year Hospital case management experience
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Care Manager RN - Bellevue - Swedish Health Services
Description
Care Manager RN - Emergency Department @ Swedish First Hill
Full time
Night Shift
Fantastic benefits and compensation package offered by Providence that begin on your first day of employment. Join us, and find out how many ways we offer you the chance to focus on what really matters - our patients.
The nurse case manager coordinates the care and service of selected patient populations through the acute care episode, across the continuum. Works collaboratively with inter-disciplinary teams, both internal and external to the organization, to improve patient care through effective utilization and monitoring of healthcare resources and assumes a leadership role to achieve desired clinical, financial, and resource outcomes.
Acts as resource and provides oversight for the Case Management Associate for discharge planning and utilization activities
•Coordination: Integrates the work of the healthcare team by coordinating resources and services necessary to accomplish agreed-upon goals.
•Advocacy: Advocates on behalf of patients and caregivers for service access or creation, and for the protection of the patient's health, safety and rights.
•Resource Management; Assures prudent utilization of all resources (fiscal, human, environmental, equipment and services) by evaluating the options available and balancing cost and quality to assure the optimal clinical and financial outcomes.
•Accountability: Accepts responsibility and accountability for achievement of optimal outcomes within their scope of practice.
•Professionalism: Acquires and maintains knowledge and competence related to the expectations of their position and practices within their scope.
Providence caregivers are not simply valued – they're invaluable. Join our team at Swedish Shared Services and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Required Qualifications:
Preferred Qualifications:
Why Join Providence?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our mission of improving the health and wellbeing of each patient we serve.
Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at
Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
About the Team
Providence Swedish is the largest not-for-profit health care system in the greater Puget Sound area. It is comprised of eight hospital campuses (Ballard, Edmonds, Everett, Centralia, Cherry Hill (Seattle), First Hill (Seattle), Issaquah and Olympia); emergency rooms and specialty centers in Redmond (East King County) and the Mill Creek area in Everett; and Providence Swedish Medical Group, a network of 190+ primary care and specialty care locations throughout the Puget Sound. Whether through physician clinics, education, research and innovation or other outreach, we're dedicated to improving the wellbeing of rural and urban communities by expanding access to quality health care for all.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment 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. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
For any concerns with this posting relating to the posting requirements in RCW , please click here where you can access an email link to submit your concern.
Requsition ID: 406472
Company: Swedish Jobs
Job Category: Care Management
Job Function: Clinical Care
Job Schedule: Full time
Job Shift: Multiple shifts available
Career Track: Nursing
Department: 3901 SFH CASE MANAGEMENT
Address: WA Seattle 747 Broadway
Work Location: Swedish First Hill 747 Broadway-Seattle
Workplace Type: On-site
Pay Range: $ $79.84
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
PandoLogic. Category:Healthcare, Keywords:Emergency Department Manager, Location:Bellevue, WA-98005-
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