Job Abstract

Salary Range: $52.6100 - $80.8600 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education.

Primary Duties and Responsibilities

The Care Manager II (RN) utilizes clinical expertise, patient assessments, and insurance payer requirements to coordinate patients’ needs through the continuum of care including post-acute care and discharge plans. This role works in collaboration with the physicians, nurses, clinical staff, and community agencies to identify and arrange for appropriate care. Resource utilization is considered when coordinating the patients’ needs through the continuum of care. May focus more heavily on a specific aspect of Care Management like discharge planning, utilization review, and/or providing psychosocial support. May review clinician assessments and patients’ financial, family and psychosocial support to develop comprehensive discharge plans. May review records to assess for appropriate admission status, level of care, payer source, and UR contracts to validate billing. May provide psychodynamic intervention and crisis counseling to support patients and families. May educate patients and families on their healthcare options and connect them with resources. Documents pertinent patient issues, contacts and discharge plans on the medical records. Is a mandated reporter for elder, child, and spousal abuse. Performs other duties as assigned.

Education and Experience

• Five years of clinical experience in an acute healthcare system environment.
• Five years of Utilization Review experience required.
• Care Manager II (RN) – Bachelor’s or Master’s degree in Nursing (BSN/MSN) required.
• Experience in Interqual or Millennium Guidelines required.
• Experience with healthcare database systems required.
• Knowledge of Medicare guidelines preferred.

License Required

• Registered Nurse (RN) license - for Care Manager II (RN) position

Certifications Preferred

• Utilization Review, Care Management, Clinical Nursing

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.