Case Manager Registered Nurse

Prime Healthcare•Olympia Fields, IL

12d•Onsite

About The Position

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

Requirements

Minimum 5 years work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license (starting April 1, 2015).
Minimum 5 years post-graduation of an accredited school of Social Work for Licensed Clinical Social Worker (grandfathered prior to April 1, 2015).
Basic to intermediate computer skills.

Nice To Haves

RN Case Manager preferred.
Five years acute care nursing experience preferred.
At least one year experience in case management, discharge planning or nursing management, preferred.
Current BCLS certificate, preferred.
Knowledge of Milliman Criteria and InterQual Criteria preferred.

Responsibilities

Quality and resource management of all admitted patients across the continuum of health care management.
Acting on behalf of the advocate, promoting cost containment.
Demonstrating leadership to integrate health care providers for seamless delivery of care.
Facilitating and ensuring quality, clinical, and cost-effective outcomes.
Performing holistic and comprehensive admission and concurrent review of the medical record for medical necessity, intensity of service, and severity of illness.