Case Manager RN - Social Work Services

Prime Healthcare•Denville, NJ

1d•Onsite

About The Position

At Saint Clare's Health, our dedicated team of professionals is committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, Saint Clare's Health is actively seeking new members to join its award-winning team! Saint Clare's Health includes CMS 5-Star Rated hospitals and is an award-winning provider of safe, high quality, compassionate care, serving the communities of Morris, Warren and Sussex counties. Its network of hospitals and healthcare facilities include Denville Hospital, Dover Hospital, Behavioral Health Centers in Boonton, Denville, and Parsippany, and an Imaging Center in Parsippany, among other satellite locations. The hospitals have received multiple quality awards including Leapfrog “A” ratings for patient safety; Healthgrades recognition for orthopedic surgery, treatment of stroke, heart care, various surgical procedures, and more.

Requirements

Minimum 5 years' work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license
At least one year experience in case management, discharge planning or nursing management
Experience and knowledge in basic to intermediate computer skills.
Current BCLS certificate

Nice To Haves

Five years of acute care nursing experience.
CCM or obtained within 1year
Knowledge of Milliman Criteria and InterQual Criteria

Responsibilities

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 ensure 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.