Case Manager Registered Nurse

Prime Healthcare•Olympia Fields, IL

4d•Onsite

About The Position

The Case Manager Registered Nurse is responsible for the quality and resource management of patients admitted to the facility, beginning at admission and continuing across the continuum of health care management. The case manager works on behalf of the patient as an advocate, promotes cost containment, and demonstrates leadership in integrating health care providers to support seamless care delivery. The role uses a methodology intended to achieve quality, clinically appropriate, and cost-effective outcomes. It includes holistic and comprehensive admission and concurrent reviews of medical records to assess medical necessity, intensity of service, and severity of illness.

Requirements

For applicants subject to requirements effective April 1, 2015: at least five years of post-graduation work experience and a current state Registered Nurse license.
For grandfathered applicants prior to April 1, 2015: at least five years post-graduation from an accredited school of social work and Licensed Clinical Social Worker status; an RN Case Manager is preferred.
Experience and knowledge in basic to intermediate computer skills.

Nice To Haves

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

Responsibilities

Manage the quality and resources of patients admitted to the facility from admission across the continuum of health care management.
Advocate on behalf of patients and promote cost containment.
Integrate health care providers to support seamless delivery of care.
Conduct holistic and comprehensive admission and concurrent medical record reviews for medical necessity, intensity of service, and severity of illness.
Facilitate quality, clinical, and cost-effective outcomes.