What are the responsibilities and job description for the Care Manager/Utilization Review RN position at Summit Pacific Medical Center?
Get to know Summit Pacific Medical Center:
Your trusted partner in Health and Wellness, Summit Pacific is a vibrant and expanding public hospital district that operates a Critical Access Hospital with a Level IV trauma designation, three rural healthcare clinics, and a seven-day-a-week urgent care clinic. Our vision is “Through Summit Care, we will build the healthiest community in the Nation.” Our hospital is unique due to its size and accessibility. We pride ourselves on our ability to give patients quick access to a provider.
- Critical Access Hospital
- 24/7 Emergency Department
- Level II Cardiac Center
- Level III Stroke Center
- Level IV Trauma Care
To learn more about Summit Pacific, visit www.summitpacificmedicalcenter.org
Pay Range (depending on experience):
$42.20 - $62.24.
Job Summary
As a member of a multidisciplinary team, the Care Manager will be responsible for coordination of care and utilization of services for acute care patients. The Care Manager will work collaboratively with interdisciplinary teams both internal and external to the organization with a shared vision to improve patient care to achieve optimal clinical and financial outcomes.
Job Duties and Responsibilities
Continually assesses the appropriateness and timeliness of level of care, assures appropriate utilization of resources by evaluating care needs and resources available. Collaborate with interdisciplinary team to achieve optimal and cost-efficient patient care outcomes that reflect patient preferences and values. Collaborate daily with the interdisciplinary care team to support the assessment of continued need for acute hospitalization. Contribute to the development and implementation of a goal-directed, age-appropriate plan of care. Facilitate care coordination needs to support plan of care from admission through to discharge. Collaborate with internal and external resources to facilitate a safe transition from hospital to another facility or home with appropriate services. Identifies discharge barriers and initiates action to resolve. Ensure patient and family understanding of third-party payer guidelines to arrange appropriate referrals. Provides clear, timely and thorough documentation based on established department standards. Facilitates coordination for concurrent denials, including nurse or provider peer to peer. Performs patient care, where competent and assists in coordination of care efforts. Adapts to changes in the work environment. Engages others in understanding the reason for change and leads them to identify the path forward. Builds and maintains working relationships. Maintains strong working relationships and engenders trust and credibility through effective and professional interactions. Creates positive experiences for patients, customers, and co-workers. Demonstrates ongoing learning & development. Participates in ongoing skills training, competency development, and professional development. Facilitates teamwork. Actively engages in team activities. Welcomes and supports new team members; promotes a positive work environment. Fosters an environment of trust. Maintains open and honest communication. Protects privacy and confidentiality. Follows through on commitments. Provides thoughtful and constructive input for strategic planning. Participates in departmental/functional strategies and tactics. Special projects as assigned.
Organizational Responsibilities
In addition to the duties and responsibilities listed above, all employees are expected to support the Summit Pacific Medical Center mission, vision and values; comply with SPMC policies and procedures; and conduct themselves in an ethical, professional, respectful, and collaborative manner at all times.
Required Qualifications
- 2 years Registered Nursing experience in Acute Care Hospital
- 1 year RN Care Management experience
- Current WA or Multistate RN License
- Current BLS
Preferred Qualifications
- Bachelor’s degree in Nursing
- Current Care Manager Certification
Required Knowledge, Skills, Abilities
Strong organizational skills; ability to prioritize, and reprioritize, work as needed to meet objectives. Professional and effective written and verbal communication skills. Ability to identify and employ communication strategies appropriate to the audience. Grammar and punctuation skills as needed to compose professional documents. Proficient in the use of current technology and software, including intermediate to advanced Microsoft Office skills (Word, Excel, Outlook). Proven ability to handle confidential information with discretion. Ability to develop and maintain accurate documentation and records. Demonstrated teamwork and collaboration skills. Strong customer service and interpersonal skills; ability to maintain composure and interact calmly and professionally with co-workers, providers, patients and visitors in a fast-paced, high-stress environment. Ability to work independently using good judgment, problem-solving, organization, and prioritization skills to complete assignments in a timely, accurate, and effective manner.
Work Shift:
Working Location:
Elma, WashingtonBenefits:
Our uniquely designed benefits are here to support you and your family in staying well, growing professionally and achieving financial security!
We take care of you, so you can focus on delivering our mission of caring for everyone, especially the most vulnerable in our communities.
Benefits offered by SPMC:
- Competitive Compensation
- Medical
- Prescription
- Dental (including Orthodontia)
- Vision
- Healthcare FSA and daycare FSA
- Daycare subsidized benefit
- Life Insurance
- Accidental Death and Dismemberment (AD&D)
- Short- and long-term disability
- Generous employer 403b match contributions for retirement
- 457 retirement account for additional funds
- Employee Assistance Program (EAP)
- Tuition reimbursement
- Smoking Cessation Assistance
- Employee Wellness Program
- Employee Committees to participate in such as Spirit Team
- Beautiful on-site gym for employees
- Instructor led fitness classes for employees, including Yoga, Kettlebells and Bootcamps
- Walking trails on site
Additional Information:
- Summit Pacific is a vibrant and expanding nonprofit public hospital district serving east Grays Harbor County, Washington. Founded in 1982, Summit Pacific now operates three locations comprised of a critical access hospital, primary care clinics, an urgent care clinic and range of ancillary and specialty services.
- Far enough to have privacy and enjoy the small-town lifestyle, yet close enough to have the benefits of the city. There are many year-round recreational activities in and around Grays Harbor such as:
- Hiking/ walking trails – whether you’re looking for short easy walking trails or long hikes you can find many trails located either on site or just miles from Summit Pacific. There are many great hiking trails about an hour away at the Quinault Rainforest which is also the home of some of the largest trees in the world!
- Kayaking – There are many areas that are easily accessible and have beautiful views.
- Nature viewing – Multiple whale watching towers and tours, state parks, Olympic Game Farm (where you can feed the animals straight from your car)
- Fishing & Hunting – If you’re looking for areas to hunt/ fish or looking for guided tours this is a great area! Westport is just 42 miles away with many opportunities to catch or buy fresh fish off the docks!
- Other activities – Multiple museums, winery, arcades, rentable mopeds, Seabrook (vacation beach town), many areas to surf for experienced surfers and surfing lessons for those who want to learn.
- Nearby colleges – Grays Harbor College is a community college located in Aberdeen with other community colleges located in surrounding areas, as well as some state colleges and universities in other areas of WA state.
Summit Pacific Medical Center is an equal opportunity provider and employer that is committed to a policy of non-discrimination on the basis of race, sex, age, religion, color, national origin, ancestry, disability, marital status, arrest and court record, sexual orientation, and status as a covered veteran. This policy covers admission and access to, and participation in, treatment and employment in the hospital’s programs, activities, services, and employment.
This organization participates in E-Verify. E-Verify is a service that verifies authorization to work in the U.S. through the U.S. Department of Homeland Security (DHS) and the U.S. Department of Social Security (SSA). For further information on E-Verify contact DHS at 1-888-464-4218.
Salary : $42 - $62