Inpatient Care Manager; RN

Inpatient Care Manager (RN)

Advocate Condell Medical Center

FT Days

Works to enhance the effective utilization of organizational resources to assist the Medical Center in achieving its goals of high-quality, cost-effective patient care and service, and for continuity of care across the continuum. Functions in a manner that supports compliance with regulatory standards and agency requirements.

• Conduct complete assessments, establish appropriate plans, and initiate interventions within desired time frames.
• Collaborate and negotiate effectively with patient, family, and team while striving to achieve patient and organizational goals with regard to patient’s care needs, choice and satisfaction during discharge planning and transition of care.
• Utilize patient/family strengths in the problem‑solving process, involving the patient/family and team in decision‑making from admission through the hospital stay.
• Provide continuity of care and discharge planning services compliant with regulatory standards, coordinating relevant options and services based on assessed needs to ensure the patient/family and healthcare team is informed and able to proceed in a timely manner.
• Participate in the communication process to facilitate a smooth transition for patient, family, and staff when patients are transferred.
• Provide case‑management services related to various levels of health care, finances, housing, family discord, or illness adjustment, as per departmental scope, managing family dynamics and crisis situations in a timely and professional manner, using community resources, and educating patient/family about access to and use of services.
• Initiate internal and external referrals to assure timely progression of care and transitions.
• Document discharge planning interventions and utilization review activity per department and medical‑center standards in a timely manner.
• Perform and document accurate and timely concurrent and retrospective reviews based on approved established criteria as required by department standards.
• Communicate effectively with the healthcare team, working in partnership with Social Work and unlicensed support personnel to establish and implement a safe plan of care.
• Serve as an active member of the Outcome Facilitation Team/Patient Care Multidisciplinary Team, working closely with medical staff, hospital departments, and ancillary services to identify and resolve barriers to discharge, expedite care delivery, and report care‑coordination, discharge‑planning, and utilization‑management activities.
• Collaborate with managers, physicians, medical directors, advisory groups, and treatment teams on issues related to physician practices and best practices for the patient’s plan of care, referring cases to physician advisors as needed.
• Remain knowledgeable in healthcare regulations, reimbursement issues, and impact on length of stay and community resources; complete utilization‑management activities and provide clinical updates to payers and external review organizations, collect data, coordinate denial activity, support utilization‑management activity, and manage avoidable delays.
• Deliver CMS regulatory notices within established time frames as appropriate.
• Develop and maintain productive relationships with community‑based agencies and networks, representing Advocate Aurora Health Care positively and collaborating internally and externally to meet patient/family needs.
• Serve as an educator and expert resource to medical and hospital staff regarding admission status and acute care criteria, utilization management issues, care coordination and discharge‑planning needs, and relevant regulatory requirements.
• Demonstrate knowledge and skills necessary to provide age‑appropriate care for the patients served, applying principles of growth and development across the lifespan and using data reflective of the patient’s status to identify age‑specific needs and deliver required care.

• Registered Nurse license issued by the state in which the Team Member practices.
• Bachelor’s degree in nursing.
• Two years of clinical nursing experience.