RN Care Manager Clinical Lead

Job Description:

The RN Care Manager Clinical Leader provides leadership and clinical expertise during their shift and within their department. This position requires handling complex problems and clinical circumstances while ensuring timely and efficient processes. The RN Care Manager Clinical Leader supports effective team collaboration within the department and other members of the healthcare team. Acts as a subject matter expert and mentor for Care Management responsibilities and assists in developing staff competency programs. Additionally, the role includes performing quality assurance audits to support regulatory compliance and departmental expectations. This position participates in process improvement initiatives, conducting data analysis to identify trends, and promoting the mission, vision, and values of Intermountain Health in collaboration with Leadership. The RN Care Manager Clinical Leader maintains participation in departmental KPIs, obtains necessary certifications, and actively engages in quality improvement projects and committees focused on education, quality assurance, and evidence-based practice.

Essential Functions

• Complex Problem Handling: Trains and manages escalations on complex problems, questions, and clinical circumstances, providing expert guidance and support.

• Education and Mentorship: Models and fosters an environment of professionalism and employee engagement. Acts as a subject matter expert in their area of specialty. Serves as a mentor to the Care Management Team, acting as a reliable source of accurate and up to date practices. Functions as a preceptor in the orientation process of new hires. Collaborates with the department manager, educator, and quality consultants to assess departmental practice patterns and implement action plans to support identified competency needs. Works in collaboration with the department educator to foster an instructive and guiding atmosphere for RN Care Manager I's.

• Quality Assurance: Participates in the strategic implementation of policies, procedures, guidelines, process flows, audit tools, and staff development plans. Maintains clinical competency through performing duties as required in the RN Care Manager I job description. 
• Compliance: Functions as a resource for regulatory knowledge and provides education to the Care Management  Team, physicians, and the interdisciplinary care team. 

• Continuous Improvement: Actively participates in system and regional initiatives to improve transitions of care and avoid duplicative services. Actively participates in quality improvement, performance improvement, and key performance indicator projects, as well as CM committees focused on education content development, quality assurance reviews, compliance requirements, PPG maintenance, and evidence-based practice assurance.

Skills

• Strategic Thinking  
• Time Management
• Prioritization  
• Leadership
• Education
• Mentoring
• Quality Assurance
• Continuous Improvement
• Critical Thinking
• Communication

Minimum Qualifications

• Current Registered Nurse (RN) license in state of practice. 
• Bachelor of Science in Nursing (BSN) from an accredited institution (degree verification required). RNs hired or promoted into this role must obtain their BSN within four (4) years of hire or promotion date. If there is an existing education agreement, that agreement will take precedence.
• Demonstrated expertise in care management in an acute hospital, utilization review, or ambulatory setting.
• Care Management Certification must be achieved within 24 months of hire or promotion.
• Demonstrated experience working with computer systems. 

Preferred Qualifications  

• Master’s degree in related field .
• Demonstrated experience working in care management in another setting (clinic, hospital, home health/hospice, government, third party payor, etc.) .
• Demonstrated familiarity with ambulatory, utilization review, and hospital care management.  
• Intermediate knowledge of government and commercial health insurance related products.  
• Intermediate knowledge of Federal and State Regulations pertaining to utilization review. 
• Working understanding of diagnosis and procedure coding, episode of care, and length of stay guidelines.  

Physical Requirements

• Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
• Frequent interactions with providers, colleagues, customers, patients/clients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles.

Location:

Intermountain Health St George Regional Hospital

Work City:

St George

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

$44.42 - $65.70

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.