RN, Lead Case Manager

  • Loyola University Health System
  • Berwyn, Illinois
  • Full Time
Employment Type: Full time Shift: Description:

The Lead Case Manager position reports to the Manager of Nurse Care Management. Their specific duties include:

  • Recruiting, interviewing, hiring, and training staff.

  • Establishing policies and procedures Planning and administering budgets.

  • Supervising staff and volunteers.

  • Collecting data and other information to evaluate program impact.

  • Overseeing performance improvement projects to realize process improvement achieving targeted outcomes.

  • Preparing reports for management, boards of directors, supporters and the public. Representing the organization in public.

  • Provides coordination and lateral integration between management and patient care activities that are consistent with the Magis Patient/Family Centered Model to achieve high standards of patient care and quality outcomes.

  • The Case Manager Lead works with the multidisciplinary team including physicians, staff and payers to ensure patient's progress along the continuum of care in an efficient and cost-effective manner that ensures quality outcomes.

  • Utilizes established guidelines to support appropriate level of care throughout hospitalization.

  • Acts as a patient advocate and communication link with other departments and community resources.

  • Supports nursing staff in development of individualized, evidence-based, outcomes oriented, and safe practice.

Position responsibilities:

  • Actively participates in clinical performance improvement activities.

  • Assists in the collection and reporting of financial indicators including care readmission rates, denial and appeals.

  • Use data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients, including fiscal, clinical and patient satisfaction data.

  • Collects, analyzes and addresses variances from the plan of care/care path with physician and/or other members of the healthcare team. Uses concurrent variance data to drive practice changes and positively impact outcomes.

  • Collects delay and other data for specific performance and/or outcomes indicators as determined by Director of Care Management.

  • Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g., discharge planning).

  • Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently.

  • Indicates and leads the development, implementation, evaluation and revision of clinical pathways and other case management tools as a member of the clinical resource/team. Assists in compilation of physician profile data and regarding LOS, resource utilization, denied days, costs, case mix index, patient satisfaction and quality indicators, (e.g., readmission rates, unplanned return to OR, etc.)

  • Acts as preceptor/mentor to new hires. Assists in development of orientation schedule and helps identify individual needs for learning.

  • Assists in performance to annual department staff review Ensures safe care to patients adhering to policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.

  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.

Requirements:

  • Bachelor's degree in Nursing; Master's degree preferred.

  • 3-5 years of previous job-related experience required; 10+ years preferred.

  • Recent clinical experience in and inpatient and outpatient setting is preferred. Case management experience within the past 3-5 years is required.

  • 1-2 years of managerial experience.

  • CPR (Cardiopulmonary Resuscitation) certification.

  • Current Registered Nurse License State of Illinois

  • Specialty certification in clinical or functional area of nursing granted by a national nursing organization.

  • Case Management certification expected within 2 years of hire.

Salary Range: $35.89 - $62.91 per hour

Actual compensation will fall within the range but may vary based on factors such as experience, qualifications, education, location, licensure, certification requirements, and comparisons to colleagues in similar roles.

Trinity Health Benefits Summary

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Job ID: 483475128
Originally Posted on: 6/30/2025

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