Registered Nurse Case Manager – PRN (as needed) – JOB# 1266
Estes Park Health exists to make a positive difference to the health and well-being of all we serve. Located about 90 miles northwest of Denver, at 7,522 feet above sea level, Estes Park Health sits in the heart of the Rocky Mountains. As a gateway to Rocky Mountain National Park, the adventurous lifestyle Estes Park supplies open endless outdoor opportunities for our staff. We promote a healthy work-life balance to give our staff the time to enjoy the “playground” that is Colorado.
From pediatrics to geriatrics, Estes Park Health supplies a full spectrum of care for our friends, neighbors, and visitors in the entire Estes Park Valley and Rocky Mountain National Park. Today, over 18,000 patients—residents and visitors alike—see our health care teams for both outpatient and inpatient services
Summary of Position:
The RN Case Manager is responsible for utilization review and utilization management for patients requiring observation and inpatient care at EPH. These duties are carried out in conjunction with the Medical Social Worker.
PRN(as needed), shifts and hours will vary. *The shift and hours listed above may be subject to temporary or permanent change at any time according to the needs required to provide excellent and full services to our customers during employment.
- Required: Associates Degree in Nursing
- Preferred: Bachelor’s Degree in Nursing
- Current Colorado RN license
- Required: 3-5 years Acute Care Nursing
- Required: 1-2 years Utilization Review and quality data collection and reporting
- American Heart Association BLS.
- Preferred: Certification in UM or UR, must have within 12 months of hire
- Performs utilization review for all patients utilizing software and other utilization management tools.
- Collaborates with physicians and provides information and education pertinent to medical necessity, patient conditions and corresponding utilization criteria.
- Oversees medical necessity documentation, data collection, and analysis. This includes collaboration with providers to optimize documentation.
- Interacts and collaborates with third party payers to facilitate the provision of clinical patient information.
- Reviews admissions and provides consultative recommendations related to placement and admission criteria
- Coordinates the Swing Bed Program. Ensure all CMS and state regulations are met.
- Establishes effective working relationships with Estes Park Health (EPH) staff, referral agencies, and other facilities with whom EPH receives and transfers patients to coordinate resources and services.
- Collaborates with the RN Case Manager to ensure receiving agencies/facilities receive appropriate patient information to facilitate continuity of care.
- Participates in patient/family care conferences.
- Facilitates education to optimize patient’s discharge plan.
- Collaborates with the RN Case Manager to assess discharge planning needs of patients, taking into consideration their emotional, physical, mental and spiritual needs and involving the family if appropriate.
- Chair the Utilization Management Committee
- Perform in accordance with all local, state, and federal laws and regulatory agency standards
- All other duties as assigned.
$36.98-$55.47, plus an hourly PRN flat rate of $4.50.
A Unique Retirement Plan for you!
All employees are enrolled in a Money Purchase Pension Plan 401(a) which replaces Social Security contributions. You control the investments on-line yourself or with you financial advisor to help it grow. We also offer a 457(b) plan for you to ad additional funds to your investments.
For more information about this opportunity call Human Resources at 970-577-4544, Monday-Friday 9am-4pm (MST) or e-mail questions to firstname.lastname@example.org.
Equal Opportunity Employer: In compliance with federal law, including the provisions of Title VII of the Civil Rights Act of 1964, Section 503 and 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, EPH does not discriminate on the basis of race, sex, religion, color, national or ethnic origin, age, disability, or military service in its administration of policies, programs, activities or employment. In addition, EPH does not discriminate on the basis of sexual orientation or gender identity.
The descriptions above are listed as is at the time of posting and could change as needed at any time in accordance with state, local and federal laws.