Riley Children's Health is Indiana’s largest and most skilled pediatric system, with over 50 locations across the state. As one of the nation’s leading healthcare networks specifically for children, our multidisciplinary team of pediatric primary care and specialists can deliver and coordinate healthcare for every child because we have expertise in all areas of pediatric health. We have the only pediatric research hospital in the state and are ranked among the top hospitals in the nation according to U.S. News & World Report. Through enduring collaborations with the Indiana University School of Medicine, Indiana University School of Nursing and Indiana University School of Health and Human Sciences, Riley Children's Health is one of the top 10 sites in the United States for pediatric health research, drawing millions of dollars in biomedical research investments each year.
We also advance healthcare for children with a significant ongoing commitment to recruiting and training the next generation of pediatric physicians, scientists and healthcare providers. We are looking for new team members that are inspired by challenging and meaningful work for the good of every patient. If you are looking to grow in your career, driven by compassion and excellence, and feel a connection to this purposeful work, apply today!
This role will be full time working Monday-Friday on our day shift with a one day a week hybrid option.
A RN Case Manager plans and coordinates care for patients from pre-admission through post-discharge by working collaboratively with the multidisciplinary team. Ensures that patients are assigned the appropriate level of care, receive the appropriate services and are transitioned to the appropriate post-discharge level of care. Performs accurate, timely and effective discharge planning for patients. Works with third party payers to ensure coverage. Administers education and prevention programs.
This position is part of the Integrated Care Management department that includes MSW Social Workers and CM Consultants. This model allows the RN Case Manager to work collaboratively with their social work counterpart to work an effective discharge plan, while the consultant provides support to both disciplines..
- Previous experience working in a Pediatric or maternity setting is a plus.
As the most comprehensive medical system in Indiana, IU Health offers many different career opportunities as you grow professionally. IU Health also offers a substantial benefits package, PTO Program, 401k with a match and several other programs to meet your needs. This is just a few reasons why applying for your career with IU Health is a good choice.
- Associate's Degree in Nursing required. New ASN RNs hired after January 1, 2013, will be required to complete their BSN within 5 years of hire date.
- Requires an active Registered Nurse (RN) license in the state of Indiana or an active Nurse Licensure Compact (NLC) RN license.
- Certification in Case Management preferred.
- Knowledge of InterQual Acute Level of Care Criteria and Federal guidelines outlining coverage of inpatient and outpatient hospital services, including observation is preferred.
- Knowledge of Medicare/Medicaid, insurance and regulatory guidelines is preferred.
- Ability to comprehend third party contractual arrangements is preferred.
- Understanding of the third party denial and appeal process is preferred.
- Requires knowledge of various software applications including Windows; Cerner; MCCM; and SMS.
- 3-5 years of experience required.
- Requires strong clinical background in acute care.
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