Mercy Health System and Rockford Health System have joined forces to become Mercyhealth, a vertically integrated, not-for-profit multi-regional health system serving northern Illinois and southern Wisconsin with five hospitals, over 80 primary and specialty center locations, post-acute retail services and a wholly owned and operated insurance company. Every day we strive to provide the best possible experience to every patient we serve...every life we touch. Our passion for making lives better drives us to continually expand our services and locations, hire the best people and provide the highest quality care every day. This is our passion. A passion for making lives better. We have an exceptional opportunity to join us as:
Registered Nurse-Case Manager Mercyhealth Hospital - Rockton Avenue Rockford, IL
Facilitating efficient patient care by assessing the appropriateness of the setting of care for each new admission, the professional we select will provide concurrent review to ensure that the patient meets criteria for continued hospital stay. This individual will promptly notify insurance companies and payers of the patient's clinical condition in order to justify insurance coverage for continued stay, and be responsible for these other vital duties:
Applying InterQual criteria to evaluate the medical necessity of hospital admission and continued stay.
Assessing patients upon admission for discharge disposition and initiating discharge planning.
Collaborating with the nursing staff, ancillary staff, physicians, and other case managers to optimize use of resources.
Conferring with physicians regarding use of resources and discharge planning.
Providing patient advocacy by ensuring that the patient and family are actively involved or represented in planning for care.
Sharing in group responsibilities, including retro-reviews with insurance companies.
Participating in activities designed to achieve annual utilization goals.
Working closely with social workers to learn basic functions, including advanced directives, surrogacy, end-of-life issues, and guardianship to carry out these functions at a basic level.
Participating in case-management rounds, patient-care rounds, case conferences, and department meetings.
Graduation from an accredited nursing program.
Current RN licensure in the state of Illinois.
Three or more years of experience in an acute-care hospital setting as a bedside nurse.
Strong organizational, written/verbal communication, customer service, and clerical skills.
Basic PC proficiency, including Windows software/MS Office.
Ability to manage stress, make decisions under pressure, manage the anger/fear/hostility/violence of others, handle multiple priorities concurrently, and work well independently.
Bachelor's of Science degree in nursing (BSN).
Experience in utilization review, utilization management, or case management.
In addition to opportunities to learn, grow, and advance, Mercyhealth offers health and dental insurance, vacation, matched retirement savings, and more. Apply online at: YourNursingCareer.org.