RN Case Manager International Patient Services – Ann & Robert Lurie Children’s Hospital of Chicago

Title of the Job: RN Case Manager International Patient Services

Location: Chicago, IL

Job Description: Ann & Robert H. Lurie Children’s Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children’s Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.Day (United States of America)Location 875 N Michigan (John Hancock)Job DescriptionJob Duties:

• Care Coordination, Collaboration and Facilitation.
• The emphasis is on care coordination and positive partnerships with multiple disciplines (clinical and non-clinical) in order to pace the care toward optimal outcomes within the appropriate level of care.
• Accountability/Responsibility:
• Collaborates with the interdisciplinary team; participating in team rounds to (as needed):
• Facilitate timely care
• Assure quality of care throughout the hospital stay, minimizing adverse outcomes.
• Initiates appropriate referrals to the internal interdisciplinary team.
• Communicates with International Finance Associate & Patient Financial Services (PFS) regarding the needs of the patient, payer and provider.
• Communicates relevant elements of the patient’s health plan benefits.
• Understands the target length of stay (LOS) on every patient at the time of the initial review and identifies the anticipated date of discharge for planning and care coordination purposes.
• Maintains an open line of communication with other disciplines regarding the target LOS and anticipated discharge date.
• Documents all team, physician and patient/family communication and concerns pertaining to coordination of care and services.
• Assists manager with case intake and triage process, as needed.
• Discharge Planning
• Utilizes the nursing process to conduct a thorough assessment of discharge needs, beginning at admission and as care needs evolve. The goal is to assure a seamless and safe patient transition to the most appropriate level of care that has the identified resources to meet the medical, nursing and psychosocial needs of the patient. The RN Case Manager collaborates with the interdisciplinary team in the identified plan for referral, transfer or discharge of the patent to another level of care.
• Accountability/Responsibility:
• Develops and effectively utilizes a network of information regarding community resources, as applicable to the international patient and family.
• Coordinates the discharge planning process in collaboration with other professional members of the interdisciplinary team.
• Appropriately delegates within the scope of practice, discharge planning activities and functions to others involved with discharge planning; case manager associates or other non-licensed personnel performing discharge activities.
• Identifies the appropriate level of post hospitalization care and services required.
• Develops the post-hospital plan of care with the patient and family, the clinical team, and external resources.
• Communicates and documents discharge planning needs.
• Provides necessary patient teaching relevant to discharge needs and/or post hospital care arrangements prior to discharge.
• Assesses the patient prior to discharge to determine if the plan is appropriate and makes necessary revisions.
• Keeps the interdisciplinary care team informed regarding details of the discharge plan.
• Communicates essential information to the next care provider.
• Payer Coordination
• Has the current knowledge of applicable regulations and laws pertaining to the Out of Country (OOC) payers including OOC embassy, OOC international insurance, and OOC self pay. Works with the interdisciplinary team to ensure that the care and services provided are medically necessary, delivered efficiently and timely, and at the appropriate level of care to meet payer requirements and established financial and performance benchmarks.
• Accountability/Responsibility:
• Notifies Admitting Department/IPS of errors or needed changes in patient data including changes in physician orders/incorrect admission status designation.
• Coordinates internal and external services to avoid under or over utilization of resources.
• Facilitates or participates in interdisciplinary team meetings or rounds.
• Reviews record including physician orders and documents admission, concurrent, discharge reviews and retrospective reviews as assigned.
• Communicates with physicians regarding the level of care or admission status when appropriate criteria are not met for inpatient, observation or continued stay.
• Provides and documents concurrent reviews or other information requested by the payer within required timeframes.
• Professionalism, Quality, Growth and Safety
• Employees will conduct their job functions in a manner consistent with their professional licensure and will demonstrate willingness to learn, improve, grow and achieve.
• Accountability/Responsibility:
• Demonstrates responsibility for professional development and growth including identifying continuing education needs and seeking learning opportunities that will enhance job performance and professional satisfaction.
• Effectively organizes work priorities.
• Demonstrates compliance with facility and departmental safety and security policies and practices.
• Educates hospital team members and physicians about the Case Manager Role and scope of RN practice.
• Supports the hospital quality, risk and performance improvement programs.
• Demonstrates culturally aware care principles.

Qualifications, Required:BSN or higher required, and RN licensure in the state of Illinois (active and in good standing).Three to five years relevant clinical experience as a RN with current knowledge of health care trends and practices related to pediatric healthcare and case management.Working knowledge of hospital revenue cycle and payer reimbursement methodologies.Experience working in partnership with healthcare professionals and support staff.Strong problem-solving skills.Demonstrated flexibility and ability to adjust in a changing environment.Proficiency with Excel, PowerPoint, and other database tools/applications.Excellent written and verbal communication skills.Additional Qualifications, Preferred:Certification in Case Management (CCM), preferred or ability after 1 year in role.Experience with InterQual and Midas+ preferred.Knowledge and experience working with international patients, hospitals, and embassies.Ability to speak Arabic or Spanish, preferredEducation Bachelor’s Degree: Nursing (Required)–Benefit StatementFor full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:Medical, dental and vision insuranceEmployer paid group term life and disabilityEmployer contribution toward Health Savings AccountFlexible Spending AccountsPaid Time Off (PTO), Paid Holidays and Paid Parental Leave403(b) with a 5% employer matchVarious voluntary benefits:Supplemental Life, AD&D and DisabilityCritical Illness, Accident and Hospital Indemnity coverageTuition assistanceStudent loan servicing and supportAdoption benefitsBackup Childcare and EldercareEmployee Assistance Program, and other specialized behavioral health services and resources for employees and family membersDiscount on services at Lurie Children’s facilitiesDiscount purchasing programThere’s a Place for You with UsAt Lurie Children’s we embrace and celebrate diversity and equity in a serious way. We are committed to building a team with a variety of backgrounds, skills, and viewpoints — recognizing that diverse identities strengthen our workplace and the care we can provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging and allyship. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care.Lurie Children’s and its affiliates are equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.Support email:

Company Name: Ann & Robert Lurie Children’s Hospital of Chicago

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