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RN Case Manager, Clinical Improvement, Full-Time

Company: Colorado West Healthcare System, dba Community Hos
Location: Grand Junction
Posted on: April 3, 2021

Job Description:

The Job: Under general supervision is responsible for ongoing development, implementation, and evaluation of processes of the CWHS Case Management Plan. The Case Management function is a highly collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's/patient's health and human services needs. The RN Case Manager provides advocacy, communication, collaboration, resource management, and education to interdisciplinary team members of CWHS. Responsible for conducting admission and concurrent review of patients, assessing appropriate level of care and medical necessity, assessing patient discharge needs and provision of services necessary to facilitate a safe and timely discharge. Effective allocation of the hospital's resources while encouraging provision of high quality patient care is essential in this role. Is cognizant of regulations and policies of all review organizations relating to billing of the fiscal intermediaries and implements processes and changes to meet the Federal/State regulations and CMS Conditions of Participation.

Work Schedule: Full Time

Location: Community Hospital


  • Maintain and improve the case management system using ongoing interaction with patients, physicians, and other health providers to meet designated clinical, operational, and financial outcomes for aggregate patient populations.
  • Assist physicians, patients, families, staff and payers in providing care for patient populations that is appropriate, effective, and cost efficient.
  • Coordinates clinical review requests from payer sources to ensure timely reviews and ultimately timely payments to the hospital.
  • Attend and actively participate in all departmental and interdepartmental meetings relative to Case
  • Management/Social Services/Discharge Planning functions.

    • Associate's Degree in Nursing, Bachelor's Degree in Nursing (preferred)
    • At least three (3) years of clinical experience in a hospital setting and at least two (2) years of case management experience in a hospital setting
    • Certification in case management (preferred)
    • Current unrestricted Registered Nurse license in the State of Colorado (required)
    • Willing to obtain Case management certification within 3 years
      This position's pay range is: $26.43 to $37.00 per hour, depending on education and experience.

      Discretionary bonuses, relocation expenses, merit increases, market adjustments, recognition bonuses and other forms of discretionary compensation may be paid to eligible employees based upon organizational and individual performance.


      Employees are eligible to participate in an attractive benefits package including medical, dental, vision, paid time off, education assistance, 403(b) with employer matching, and more. Eligibility is based on employment status. Details regarding specific benefit you may be eligible for will be discussed during the hiring process.

      Be Extraordinary. Join Us Today!

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Keywords: Colorado West Healthcare System, dba Community Hos, Grand Junction , RN Case Manager, Clinical Improvement, Full-Time, Healthcare , Grand Junction, Colorado

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