Care Manager, Care Coordination

Responsibilities Assists the patient throughout their hospital experience to insure the right care is provided at the right time every time by focusing on the person and family. Insures the patient's active participation and decision making in their care. The major responsibilities of the role are: collaborating with patients, family and caregivers to deliver care consistent with best practice; responsible for organizing and facilitating patient care; analyzing clinical information and making recommendations regarding appropriateness of care. Assures the financial integrity of the organization by decreasing waste, providing insurance updates and concurrent appeals and by monitoring over and under utilization. Coordinates with physicians to assure clinical documentation supporting the assigned DRG. Facilitates interdisciplinary complex case rounds.  As an ongoing process, assesses the patient daily to insure the right care is delivered at the right time by identifying delays and removing barriers. Education: Graduate of an accredited Bachelor of Nursing degree program required. 
Licensures/Certifications: Current license to practice as a Registered Nurse in the State of Washington.
Experience and Skills: Must have an understanding of biological, social and behavioral theory normally acquired through the completion of a Bachelor of Nursing degree.  A minimum of three years registered nursing experience in an acute care hospital required.

Must possess adequate knowledge to perform clinical assessments; plan patient care; identify, plan and coordinate solutions to barriers that impede the delivery of the right care at the right time, the first time; educate and orient patients and family.  Experience in partnering with physicians and other healthcare providers to provide patient centered care that is consistent with established clinical care pathways and/or clinical standards. Ability to interpret clinical standards (such as Interqual or Milliman) and apply criteria to patient care.  Demonstrated ability to creatively problem solve on behalf of the patient, family, hospital or payer.  Ability to negotiate with doctors, nurses and other healthcare providers.  Ability to educate physicians, caregivers, patient, family, payor and/or administrative staff.  Must have knowledge of human growth and development to modify services to the age and developmental stage of the patient. 
Ability to use a computer for clinical data entry or retrieval. Demonstrated efficiency with a keyboard and mouse.  Knowledgeable in the use of general office equipment (i.e. telephones, voice mail, fax machines and photocopiers).  Excellent verbal communication skills in person and on the telephone.  Ability to communicate effectively with staff of all job categories.  Ability to read, write legibly, understand and communicate clearly in English. Demonstrated ability to use basic math skills.

Ability to organize and prioritize work. Ability to act independently, utilizing critical thinking and problem solving skills.  Must be a mature individual capable of independent decision-making and ability to work collaboratively with others in a variety of settings and disciplines. Demonstrated ability to lead and work with a wide range of staff as part of an interdisciplinary team. Ability to work collaboratively with others in a complex healthcare setting. Demonstrated ability to partner with physicians. Maintains skills and competencies defined in the unit specific orientation competency skill list.