RN Manager - Case Management - Inpatient

Job description

Why Mayo Clinic Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting diversity, equity and inclusion, and provides the resources you need to succeed. Responsibilities The RN Manager, Care Management provides leadership, direction, and resource management for case managers and social workers in the inpatient and ambulatory settings. The RN Manager effectively resolves utilization review and denial management issues, provides leadership in resolving psychosocial issues, and removes barriers and complexities for case managers and social workers to effectively facilitate safe discharge planning. The RN Manager collaborates internally and externally to maximize patient flow and mitigate reimbursement issues. Collaborates internally with pre-certification staff, admitting and billing office personnel, contracting staff, house supervisors, risk management, physicians, and specialty departments that impact needs during the inpatient stay and through the provision of an effective, safe discharge. External collaboration includes but is not limited to health plans, providers, and vendors that impact needs during the inpatient stay and through an effective, safe discharge. This individual has a strong working knowledge of Medicare/Medicaid, regulatory compliance mandates, auditing agencies, national coverage determinations (NCDs) and local coverage determinations (LCDs). Possesses knowledge of various payer sources, benefits, and limitations and understands and applies utilization management standards from the patient's point of entry through discharge. The RN Manager assists in developing and creates ownership for the department's vision and planning, fostering teamwork and an open creative environment for staff. The RN Manager coordinates, implements, and evaluates staff development and manages staff performance proactively and decisively. The RN Manager supports staff leadership activities, including community involvement and participation in committees and research. This individual must demonstrate knowledge of the principles of growth and development of the life span and appropriately interpret information relative to the patient's specific needs. The RN Manager, Care Management supports leadership amongst the staff through support of activities that include staff development, community involvement, and participation in committees and research. The American Nurses Association (ANA) Nursing Scope and Standards of Practice, the ANA Code of Ethics for Nurses, and the Commission for Case Manager Guideline provide the basis for practice. This role is eligible for TN sponsorship. Holders of F1 status eligible for post-completion OPT are welcome to apply. This role is NOT eligible to participate in the F-1 STEM OPT extension program. Successful sponsorship will require state licensure and completion of the VisaScreen or equivalent certification. Qualifications Qualifications: Graduate of a Bachelor’s degree in nursing program (BSN Required). Five years of hospital-based case management, including discharge planning and utilization review experience. Knowledge of Medicare/Medicaid and other payer sources, benefits, and limitations. Strong inpatient utilization review knowledge related to status and process. Demonstrated strong clinical nursing practice in adult medical/surgical/ICU areas. Must be highly motivated, flexible, innovative, and self-directed. Excellent communication and interpersonal skills and proficiency with computers. Preferred Education: Master’s degree. Preferred Experience: Five years of supervisory/management experience in an inpatient medical setting. Preferred working knowledge of Interqual Criteria and MIDAS License and Certifications: Current RN licensure from Arizona. Exemption Status Exempt Compensation Detail $100,984 - $151,549 / year Benefits Eligible Yes Schedule Full Time Hours/Pay Period 80 Schedule Details Monday - Friday 0800-1700. May require 0700 meetings and as late as 1700 meetings. If needed, may need to assist with staffing by taking an assignment. Are available to staff on a rotational basis to answer any questions on off hours. Weekend Schedule Available to staff on a rotational basis to answer questions on off hours including weekends. International Assignment No Site Description Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is. Affirmative Action and Equal Opportunity Employer As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available. Recruiter Danelle White Jobs for Humanity is partnering with Mayo Clinic to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located. Company Name: Mayo Clinic