Managed Care Provider Relations Manager jobs in Richland, WA

FT RN Resident Care Manager (RCM) position. 

Position Summary

The RN Care Manager is responsible for the coordination of the patient’s care and services. Promotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of patients. Works together with the patient and family, care team, payers, and external entities to promote a safe transition from the facility to the next provider or care setting care team, payers, and external entities to promote a safe transition from the facility to the next provider or care setting in accordance with all applicable laws, regulations, and Life Care standards.

Education, Experience, and Licensure Requirements

• Nursing diploma (associate’s or bachelor’s degree in nursing)
• Currently licensed/registered in applicable State. Must maintain an active Registered Nurse (RN) license in good standing throughout employment.
• One (1) year of clinical experience in post acute care setting preferred
• Prior case management, utilization review, and discharge planning experience preferred
• Certified Case Manager (CCM) or Board Certification in Nursing Case Management (RN BC) preferred

Specific Job Requirements

• Generate written communication that is clear, concise, and well organized
• Excellent organizational skills and be efficient in prioritizing and managing time and assignments
• Contribute to the organization’s goals and objectives and support the organizational strategic plans
• Expert knowledge in field of practice
• Make independent decisions when circumstances warrant such action
• Knowledgeable of practices and procedures as well as the laws, regulations, and guidelines governing functions in the post acute care facility
• Implement and interpret the programs, goals, objectives, policies, and procedures of the department
• Perform proficiently in all competency areas including but not limited to: patient rights, and safety and sanitation
• Maintains professional working relationships with all associates, vendors, etc.
• Maintains confidentiality of all proprietary and/or confidential information
• Understand and follow company policies including harassment and compliance procedures
• Displays integrity and professionalism by adhering to Life Care’s Code of Conduct and completes mandatory Code of Conduct and other appropriate compliance training

Essential Functions

• Demonstrate efficient use of relevant computer systems including but not limited to the ability to enter and retrieve data
• Serve as liaison to external case managers, family, physicians, and community resources
• Train and education patients, families, associates, and other providers of care
• Implement the standards of practice for care management, ethical performance, and functions relevant to coordination of care
• Exhibit excellent customer service and a positive attitude towards patients
• Assist in the evacuation of patients
• Demonstrate dependable, regular attendance
• Concentrate and use reasoning skills and good judgment
• Communicate and function productively on an interdisciplinary team
• Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours
• Read, write, speak, and understand the English language

An Equal Opportunity Employer