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Catholic Health Initiatives RN - Care Manager, Denials Management in BREMERTON, Washington

RN - Care Manager, Denials Management

Location: BREMERTON, WASHINGTON, UNITED STATES

Requisition #: 2019-R0257916

Post Date: Nov 21, 2019

RN - Care Manager, Denials Management

Position Type: Regular, Full-time

Shift Schedule: Mon - Fri; 8am - 4:30pm

Weekends Required: None

Holidays Required: Occasional

Scheduled Hours per 2 week Pay Period: 80

Primary Location: Bremerton, WA

CHI Franciscan Health has exciting and rewarding careers with competitive salaries and benefits. We are a part of a family of hospitals, health care services, and medical providers delivering compassionate care to people throughout the South Puget Sound. We are part of Catholic Health Initiatives, one of the largest not-for-profit health care systems in the country.

Our mission is to deliver high quality care that meets our patients' medical needs while providing emotional and spiritual support to patients and their families. We believe this three-part approach — physical, emotional, and spiritual — is essential to healing the whole person. Come join our team!

Job Summary:

As a member of a multidisciplinary team, in a leadership role, is responsible for coordination of patient care along the full continuum and/or for a target population. Through intervention, promotes the appropriate utilization of resources, identifies and addresses care gaps, promotes health behavior changes for patients to better manage their illnesses and recovery (if not chronic), and analyses readmissions to the acute setting post hospitalization. As a result, optimal clinical, financial, functional and health status improvements in the target population will be accomplished.

Incumbents will use professional judgment, independent analysis and critical-thinking skills to apply clinical guidelines, policies, and regulatory requirements, etc. to determine the appropriate level of care. Monitor’s patient’s clinical status and needs in order to ensure appropriate intensity of services and anticipate and prepare for transitions of care. Interventions will be targeted towards effective management of each episode of care and the seamless transition to the next level of care. The goal will be towards promoting patient engagement and participation in their care at their highest attainable level. The desired result is management of the patient in the least restrictive environment possible.

Incumbents are also accountable for demonstrating a strong commitment to promoting excellence every day by maintaining and demonstrating competent professional practice and engaging in opportunities for professional growth.

Essential Duties:

  • Facilitates coordination of a multidisciplinary plan of care to guide patient progress to promote the achievement of optimal clinical, quality, and cost effective outcomes.

  • Completes documentation responsibilities in keeping with hospital and department policy.

  • Performs evaluation of patient’s care and progress for the episode of care and/or across the continuum for the identified population.

  • Attends and participates in process improvement activities related to specific populations, department(s) and organization wide initiatives.

  • Adheres to and exhibits CHI Franciscan Health’s Core Values of Reverence, Integrity, Compassion and Excellence.

Your time at work should be fulfilling. Rewarding. Inspiring. That’s what you’ll find when you join one of our non-profit CHI facilities across the nation. You’ll find challenging, rewarding work every day alongside people who have as much compassion as you. Join us and together we’ll create healthier, stronger communities. Imagine your career at

Education/Work Experience:

Graduation from an accredited school of nursing plus three years of recent clinical work experience in the specialty area or related clinical specialty in a hospital setting within the past five years that demonstrates attainment of the requisite job knowledge skills/abilities. Experience with utilization management, discharge planning and/or case management is preferred.

Licensure/Certification:

Active Washington State license as a Registered Nurse is required.

Certification in case management from the Commission for Case Management Accreditation (CCM). The American Nurses Credentialing Center (RN-BC), or the American Care Management Association is desirable.

Certification in Psychiatric Mental Health (RN-BC), American Nurses Credentialing Center preferred.

Join us at Catholic Health Initiatives, and become a part of our faith-based health system.

Additional Information

  • Requisition ID: 2019-R0257916

  • Schedule: Full-time

  • Shift: Day Job

  • Market: CHI-Franciscan System Services

About Us

We are excited to share that CHI was named as one of America’s Best Employers 2019, by Forbes. Clickhereto learn more.

Chances are, you’re here because you’re looking for a career offering greater opportunity, challenge and fulfillment. We’re confident you’ll find all three at CHI. As one of the nation’s largest nonprofit health systems, we offer a wealth of careers across more than 101 hospitals in 18 states. Our faith-based health system welcomes you to share in our mission of building healthier communities, whether as a surgeon in the operating room or an administrator in a conference room. When you work in a supportive environment with like-minded professionals, wonderful things happen. Learn More

Equal Opportunity Employment

Consistent with our Core Values, Catholic Health Initiatives employers are EEO/AA/M/F/Vets/Disabled Employers. Qualified applications will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identification, protected veteran status, disability or any other legally protected characteristic

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