LOCATION: JOHN H. STROGER HOSPITAL - MANAGED CARE/COUNTYCARE
Under the direction of the Manager of Care Management – CountyCare, the Care Management Nurse Coordinator works closely with network providers, delegated care Management Entities (CMEs), benefit managers and managed care staff to coordinate services for members. This position contributes toward the development, implementation, evaluation and continuous improvement of the care management services for CountyCare. The incumbent acts as a liaison to care management teams ensuring the staff operates in adherence to CountyCare protocols, policies, and procedures.
Must be licensed as a Registered Professional Nurse in the State of Illinois.
A Bachelor's degree from an accredited college or university is required. (Must provide official transcripts at time of interview)
A minimum of two (2) years of work experience in care coordination or case management as primary responsibility is required.
A minimum of two (2) years of work experience in acute care nursing is required.
A minimum of one (1) year of work experience in a managed care organization or health plan is required.
A minimum of one (1) year of experience in ambulatory nursing, home health, or public/community health is required.
Prior experience creating and implementing plans of care for complex patients is required.
Prior experience working with Medicare, Medicaid, and Third Party Payer review requirements is required.
Prior experience working with medically under-served population(s) is required.
Master's degree from an accredited Master's program in Nursing, Public Health or Business is preferred.
Prior experience using Millman or InterQual criteria sets, and an understanding of clinical algorithms is preferred.
Experience working with the patient centered medical home model of care delivery is preferred.
Experience working with mental health care and/or substance abuse use disorder treatment services is preferred.
When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service
To take advantage of this preference a Veteran must :
· Meet the minimum qualifications for the position .
· Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question,
The Cook County Health & Hospitals System’s mission is to deliver integrated health services with dignity and respect regardless of a patient’s ability to pay; foster partnerships with other health providers and communities to enhance the health of the public; and advocate for policies that promote the physical, mental and social wellbeing of the people of Cook County. CCHHS is comprised of two hospitals, John H. Stroger, Jr. Hospital and Provident Hospital, a robust network of more than a dozen community health centers, the Ruth M. Rothstein CORE Center, the Community Triage Center, the Cook County Department of Public Health, Cermak Health Services, which provides health care to individuals at the Cook County Jail and the Juvenile Temporary Detention Center, and CountyCare, a Medicaid managed care health plan.The system cares for more than 300,000 patients each year and its physicians are experts in their fields, committed to providing their patients with comprehensive, compassionate and cutting-edge care. Today, CCHHS is transforming the provision of health care in Cook County by promoting community-based primary and preventive care, growing an innovative, collaborative health plan and enhancing the patient experience.