Integrated Case Manager

Job Summary

Utilizing the case management process, the Integrated Case Manager (ICM) coordinates transitional care for children/families for an assigned medical team. The ICM collaborates with providers to assure all patient stays meet the needs of the patient to discharge in a safe and efficient manner. Based on departmental needs, the ICM also performs the functions of a Hospital Case Manager (HCM).

• Understands and satisfies the continued needs of neonate, infant, toddler, pre‑school, school‑age, adolescent, and/or young adult patients in regard to their growth and development as they transition home or to an alternate level of care.
• Demonstrates teamwork within the department by assisting other staff members as necessary.
• Initial and ongoing assessment of the patient’s clinical situation, including physical and behavioral needs.
• Leads the implementation and management of a care coordination plan through collaboration with the care coordination team, family/caregivers, treating providers, hospitals, and community agencies; attends all patient rounds with assigned provider teams.
• Reviews all outpatient cases to conduct daily level of care assessment using Inter Qual Criteria; documents potential denials when criteria are not met; discusses differences in LOC assignment; utilizes clinical protocols, algorithms, paths where available.
• Ensures appropriate services across the continuum of care and continuity across service levels; arranges outreach calls or visits for after‑care services; communicates self‑pays and out‑of‑network payors to financial clearance; educates families about outpatient/observation level of care and potential co‑pays.
• Hospital Case Manager: performs all functions of the Hospital Case Manager.

• Associate’s Degree Nursing required.
• Bachelor’s Degree Nursing preferred.

• 2+ years of case management experience; 2‑3 years preferred.
• Previous experience in pediatrics, discharge planning, home care, and/or other care of the child/family preferred.

• Independent judgment, analytical ability, systems thinking, and highest level of interpersonal communication.
• Ability to collect pertinent clinical information while maintaining rapport with providers.
• Skill in interpreting clinical treatment information to link patients with providers and resources throughout the continuum of care.
• Expertise in Utilization Management and understanding of Inter Qual criteria preferred.
• Computer knowledge and skills in WORD, Outlook, Excel, and Internet use.
• Ability to learn and navigate hospital‑specific programs such as MIDAS, Epic, and Electronic Health Records.
• Understanding of the impact of healthcare delivery systems on the patient and family.
• Knowledge of patient care, case management theory and practice preferred.

• License RN‑Registered Nurse (30) – State of Wisconsin required.
• CCM‑Certified Case Manager – Commission for Case Manager Certification preferred.

• Provides care appropriate to patient population and as described in applicable policies and procedures.

• This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that may be requested in the performance of this job.
• Employment is at‑will. This document does not create an employment contract, implied or otherwise.

Hours:

7A‑3:30P

Children’s Wisconsin is an equal opportunity / affirmative action employer. We are committed to creating a diverse and inclusive environment for all employees. We treat everyone with dignity, respect, and fairness. We do not discriminate against any person on the basis of race, color, religion, sex, gender, gender identity and/or expression, sexual orientation, national origin, age, disability, veteran status, or any other status or condition protected by the law.