Work where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemIntegrated Care Partners ICP is a physician led clinically integrated health care network whose mission is to assist our members in providing the highest quality care at the most reasonable cost for our patients in the current rapidly changing medical environmentPosition SummaryThe Clinical Resource Management Nurse is an integral part of the Care Management team whose focus is on performing a timely level of care assessment ideally at the immediate point of entry into the health system to ensure that patients are assigned the most appropriate patient class based on their clinical needs incorporating the judgment of their provider The Clinical Resource Management Nurse is able to work autonomously and swiftly managing a high volume of complex cases across all HHC system hospitalsPosition ResponsibilitiesApply standard criteria and guidelines to assist in determining andor to validate the patient class assigned by the providerDocument review and findings as well as any additional information relevant to the case as directed and appropriatePartner with the Emergency Department andor the Admitting Provider to ensure the patient class assigned is appropriate given the patientrsquos clinical presentationAct as a resource and subject matter expert to the Emergency Department andor the Admitting Provider on aspects of patient class and level of care determinationEscalate cases to designated Physician Advisor resource when assigned level of care is not appropriate and Emergency Department or Admitting Provider is unwilling to consider recommendations for alternativeMaintain knowledge of industry standards and regulatory requirements which influence patient class and level of care determinationsProvide education sessions to constituency groups as needs are identified andor as requestedSupport needs of the department in the event of a critical demand or a decrease in volumes by performing a review of work ques crafting appeal responses etcEnsure any information critical to the care and progression of the patient gleaned during the review process is relayed to the Care Manager responsible for the patientComplete assignments to demonstrate expert knowledge of criteria as requestedOther duties as assignedWork where every moment mattersEvery day over Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemIntegrated Care Partners ICP is a physician led clinically integrated health care network whose mission is to assist our members in providing the highest quality care at the most reasonable cost for our patients in the current rapidly changing medical environmentPosition SummaryThe Clinical Resource Management Nurse is an integral part of the Care Management team whose focus is on performing a timely level of care assessment ideally at the immediate point of entry into the health system to ensure that patients are assigned the most appropriate patient class based on their clinical needs incorporating the judgment of their provider The Clinical Resource Management Nurse is able to work autonomously and swiftly managing a high volume of complex cases across all HHC system hospitalsPosition ResponsibilitiesApply standard criteria and guidelines to assist in determining andor to validate the patient class assigned by the providerDocument review and findings as well as any additional information relevant to the case as directed and appropriatePartner with the Emergency Department andor the Admitting Provider to ensure the patient class assigned is appropriate given the patientrsquos clinical presentationAct as a resource and subject matter expert to the Emergency Department andor the Admitting Provider on aspects of patient class and level of care determinationEscalate cases to designated Physician Advisor resource when assigned level of care is not appropriate and Emergency Department or Admitting Provider is unwilling to consider recommendations for alternativeMaintain knowledge of industry standards and regulatory requirements which influence patient class and level of care determinationsProvide education sessions to constituency groups as needs are identified andor as requestedSupport needs of the department in the event of a critical demand or a decrease in volumes by performing a review of work ques crafting appeal responses etcEnsure any information critical to the care and progression of the patient gleaned during the review process is relayed to the Care Manager responsible for the patientComplete assignments to demonstrate expert knowledge of criteria as requestedOther duties as assignedEducationRegistered Nurse is required BSN in Nursing is preferredExperienceAt least five years of relevant clinical experience Acute care or managed care utilization review is preferredLicensure Certification RegistrationCurrent State of Connecticut RN licenseKnowledge Skills and Ability RequirementsFamiliarity with clinical careAble to influence and negotiateCritical thinking astute assessment and confident in decision makingStrong interpersonal and communication skillsKnowledge of Interqual or equivalent criteria and reimbursement guidelinesWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour momentEducationRegistered Nurse is required BSN in Nursing is preferredExperienceAt least five years of relevant clinical experience Acute care or managed care utilization review is preferredLicensure Certification RegistrationCurrent State of Connecticut RN licenseKnowledge Skills and Ability RequirementsFamiliarity with clinical careAble to influence and negotiateCritical thinking astute assessment and confident in decision makingStrong interpersonal and communication skillsKnowledge of Interqual or equivalent criteria and reimbursement guidelinesWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment