Staff Nurse,Care Management Overhead
This job opening is for a Temporary Float RN position within the Central Staffing Resource Department (CSR) and services Care Management
Wage: $55.00/hr. base rate Evening Shift Differential is $5.00 per hour Night Shift Differential is $ 3.00 per hour Weekend Differential is $5.00 per hour
The RN Case Manager assesses, develops, implements, coordinates and monitors a comprehensive plan of care for each patient/family in collaboration with the physician, social worker and all members of the interdisciplinary team in the inpatient and emergency department patient care areas. The position is unique in that it combines clinical/quality considerations with regulatory/financial/utilization review demands. The position creates a balance between individual clinical needs with the efficient and cost effective utilization of resources while promoting quality outcomes.
The RN Case Manager reports directly to the Manager of Care Management. The RN Case Manager works closely with the unit-based MPLAN team in reaching unit and organization goals including length of stay, care transitions, read missions, and other quality initiatives. The RN Case Manager will recommend and document patient classification of all admissions utilizing established criterion set.
Utilization Review and Utilization Management
- Conduct clinical review on admission; review every 3 days or as requested by payer
- Determine patient classification with provider and ensure all patients placed in “ observation” classification are notified; For “inpatient” to “observation” cases, ensure Condition Code 44 billing requirements are met
- Communicates with third party payers to obtain necessary authorization for reimbursement of services.
- Obtain anticipated LOS from provider and ensure patient and multi-disciplinary team is aware
- Refer defined cases for medical secondary review and share findings with providers
- Provide advice to Revenue Cycle/HIM regarding RAC decision to appeal, denials; input into appeals; share findings with providers
- Review all cases with readmission within 30 days; report findings in Care Management software such as Allscript
- Identify opportunities for cost reduction and participate in appropriate utilization management venues
- Conducts referrals and consultation with Physician Advisor
Nursing Specific Info
Required qualifications must be met by the candidate in order to be interviewed and considered for the position. * Please note that these positions do not qualify for UMHS benefits and specific terms and conditions of employment are negotiated at the department level. These positions are not covered under the collective bargaining agreement between the U-M and the Michigan Nurses Association and the U-M Professional Nurse Council union.If you have questions regarding this posting or would like assistance with nursing opportunities please contact Nurse Recruitment at (734) 936-5183.
- Current licensure as a Registered Nurse in the State of Michigan.
- Two (2) or more years recent Care Management experience.
- Bachelor’s Degree in Nursing or Associates/diploma in nursing and a Master’s degree in Nursing
RESUME REQUIRED (for both internal & external applicants):
You must attach a complete and accurate resume to be fully considered for this position.
Required qualifications must be met by the candidate in order to be interviewed and considered for the position.
- Demonstrated flexibility.
- Demonstrated ability to work effectively with an interdisciplinary health care team.
- Demonstrated positive verbal and written communication skills.
- Demonstrated positive attitude
- Demonstrated team player skills
- Demonstrated accountability and dependability.
- Demonstrates expertise in communication and problem solving skills within all levels of the health care team, as evidenced by interviews, documentation, writing skills, and references.
- Ability to work in a team atmosphere utilizing effective delegation skills.
- Demonstrated problem solving skills.
- Demonstrates accountability/dependability as evidenced by completion of mandatories and unit based competencies within an established time frame.
- Experience floating to multiple units
- Knowledge of the University of Michigan Hospital nursing policies and practice.
- Demonstrates participation in continuous quality improvement process with documented results.
- Experience with family centered care philosophy
- Takes initiative in seeking professional growth.
- Experience with Inter-Qual
- Experience with AllScripts
- Commitment is 24 hours per 4 week scheduling block*Location: Central Staffing Resource -Michigan Medicine - Float UR
- Expected to float to like units where competent and qualified in times of decreased cases
- Inability to work for (3) months consecutively leads to automatic termination from employment
- No guarantee of work at any time. Shifts can and sometimes will be cancelled.
- Day shift 8:00 am – 4:30 pm
- Weekend and holiday shifts available
TEMPORARY FLOAT NURSE GUIDELINES
- All CSR employees are required to attend an annual educational Blitz to complete required UM mandatories and compentencies (BCLS every 2 yrs, Cardiac Arrest and maintain all other applicable certifications)
- Temporary Float Nurses are expected to work all shifts requested unless no work is available. It is the intention that all Temps will float to all units within the cluster speciality.
- A Temporary Nurse should work 24 hours per 4 week schedule block. You may request four (4), eight (8), or twelve (12) hours shifts in advance.
- Temporary Nurses in the CSR Clusters are NOT required to work weekends or holidays.
- Temporary Nurses will participate in a newly designed, streamlined, on boarding/orientation program. However, the progression of orientation will be dependent upon clinical competency, staffing needs of the individual units, and the number of hours worked by the Temporary RN.
This temporary position may meet eligibility requirements for health care benefits.
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Michigan Medicine seeks to recruit and retain a diverse workforce as a reflection of our commitment to serve the diverse people of Michigan and to maintain the excellence of the University. We welcome applications from anyone who would bring additional dimensions to the University’s research, teaching, and clinical mission, including women, members of minority groups, protected veterans, and individuals with disabilities. The Department of Nursing, like the University of Michigan as a whole, is committed to a policy of nondiscrimination and equal opportunity for all persons and will not discriminate against any individual because of race, color, national origin, age, marital status, sex, sexual orientation, gender identity, gender expression, disability, religion, height, weight, or veteran status.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.